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PMID: 19890677 Published · ppublish English Journal Article Review

Prevention of type 2 diabetes: risk status, clinic, and community.

Journal of general internal medicine ·Vol. 25 ·No. 2 ·2010-02-00 ·Pages 154-7

Narayan KM, Williamson DF

Abstract

Although the idea of preventing type 2 diabetes has been articulated since the discovery of insulin, only in the past decade have clinical trials demonstrated that diabetes can be prevented or delayed. These trials found lifestyle intervention reduces diabetes incidence by over 50% and is more efficacious than metformin. Evidence from prevention trials comes from persons with "pre-diabetes" in which blood glucose levels are elevated but not yet in the diabetes range. In normoglycemic persons, lifestyle or drug intervention has little impact on diabetes incidence. Prevention programs are often conducted outside the clinical sector where participants' glycemic status is usually unknown; these programs may include many normoglycemic participants, which greatly reduces cost-effectiveness. An economically sustainable system for diabetes prevention will require effective partnerships among the clinical sector, community-based lifestyle programs, and third-party payers to ensure that limited resources for diabetes prevention are focused on persons at high risk of diabetes.

MeSH Terms
Attitude to Health Cost-Benefit Analysis/economics Diabetes Mellitus, Type 2/economics,epidemiology,prevention & control Humans Prediabetic State/economics,epidemiology,prevention & control Residence Characteristics Risk Factors Risk Reduction Behavior
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Narayan K M Venkat
Hubert Department of Global Health, The Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA. [email protected]
Williamson David F
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Article Info
Journal
Journal of general internal medicine
Abbr.
J Gen Intern Med
ISSN
1525-1497
DOI
10.1007/s11606-009-1148-9
Email
[email protected]
Published
2010-02-00
Epub
2009-00-05
Pages
154-7
Language
English
Region
United States
NLM ID
8605834
PMCID
PMC2837490
Subset
IM
External Links
PubMed source DOI: 10.1007/s11606-009-1148-9 PMC Full Text View journal details
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