Abstract
The worldwide epidemic of type 2 diabetes mellitus is a major challenge for medical care and health-care systems. Type 2 diabetes is a complex metabolic disease developing in genetically susceptible individuals as a result of environmental and lifestyle risk factors. These risk factors are well known: obesity, central adiposity, physical inactivity and an unhealthy diet. To prevent the personal and socioeconomic burden of diabetes, the effort to prevent the disease needs to be started before the its onset and should address all susceptibility factors. Four recent studies have shown that prevention of type 2 diabetes is possible and that reinforced lifestyle intervention/modification can significantly reduce the onset of the disease. The studies showed repeatedly that diabetes was prevented from developing in about 60% of those with an increased diabetes risk compared to a control group. Early pharmacological preventive strategies have yielded a 25–30% risk reduction. These studies have convincingly demonstrated that the primary aim in prevention of type 2 diabetes is the stabilization of glucose tolerance due to improvement of insulin resistance. Based on the results of the studies, the intervention protocol focused on achieving five core goals. With respect to the worldwide burden of diabetes, these studies offer a compelling evidence base for the translation of the research findings into community-based prevention strategies on a national scale. The workgroup “Diabetes Prevention” at the German Diabetes Association together with the German Diabetes Foundation have developed a concept for a National Diabetes Prevention Programme. To achieve this, a large number of partners are necessary. For the implementation of such a programme at the population level, the intervention is primarily based on reinforced behaviour modification (lifestyle and physical activity). In addition, the pharmacoprevention of type 2 diabetes will be of increasing importance.
Published Version
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