Prevention of Type 2 Diabetes - Lessons we have Learnt for Implementation

Abstract

The challenge today is to implement successful diabetes prevention programs in general health care. Even if not all questions for the prevention of diabetes are answered, we have today overwhelming evidence that diabetes can be prevented or delayed in high risk population through lifestyle modification or pharmacological interventions. This information has to be translated now into well-defined strategies for screening and treating high risk population in daily practice. It is necessary then to develop and implement prevention programs into clinical practice considering scientific aspects and practical requirements during implementation. While translating the scientific evidence into population based intervention strategies more and more questions arise, mostly related to economic and structural requirements during implementation. At the end, giving the right answers to these questions will decide about the success of implemented prevention strategies. Here, we will try to answer some of the questions which arose during the implementation of a prevention management concept into clinical practice. We focus on the development of a structured prevention management program which will enable implementation of diabetes prevention into clinical practice.

Key words

Prevention of type 2 diabetes - quality management - intervention concept - implementation - public health - FINDRSIC

References

• 1 Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic.  Nature. 2001;  414 782-787
• 2 Haffner SM. Can reducing peaks prevent type 2 diabetes: implication from recent diabetes prevention trials.  Int J Clin Pract Suppl. 2002;  129 33-39
• 3 Nestle M. Preventing childhood diabetes: the need for public health intervention.  Am J Public Health. 2005;  95 1497-1499
• 4 Schwarz PE. Congress report from the American Diabetes Association 66^th Annual Scientific Sessions in Washington, USA.  Exp Clin Endocrinol Diabetes. 2006;  114 ((10)) 605-610
• 5 Schwarz PE. Report from the Congress of the American Diabetes Association (ADA): Orlando 2005 -65th Annual Scientific Sessions in San Diego, CA, USA, June 10th-14th 2005.  Exp Clin Endocrinol Diabetes. 2005;  113 ((8)) 475-479
• 6 Valensi P. et al . Pre-diabetes essential action: a European perspective.  Diabetes Metab. 2005;  31 606-620
• 7 Schwarz PE, Bornstein SR. Pre-diabetes and metabolic syndrome in Germans.  Horm Metab Res. 2006;  38 359
• 8 Kanauchi M. et al . New “pre-diabetes” category and the metabolic syndrome in Japanese.  Horm Metab Res. 2005;  37 622-626
• 9 Diamantopolous EJ. et al . Metabolic syndrome and prediabetes identify overlaping but not identical populations.  Exp Clin Endocrinol Diabetes. 2006;  114 ((7)) 377-383
• 10 Haslbeck KM. et al . The AGE/RAGE/NF-(kappa)B pathway may contribute to the pathogenesis of polyneuropathy in impaired glucose tolerance (IGT).  Exp Clin Endocrinol Diabetes. 2005;  113 ((5)) 288-291
• 11 Fox CS. et al . Increasing cardiovascular disease burden due to diabetes mellitus: the Framingham Heart Study.  Circulation. 2007;  115 1544-1550
• 12 Schwarz PE. et al . Haplotypes in the promoter region of the ADIPOQ gene are associated with increased diabetes risk in a German caucasian population.  Horm Metab Res. 2006;  38 447-451
• 13 Gouni-Berthold I. et al . The K121Q polymorphism of the plasma cell glycoprotein-1 gene is not associated with diabetes mellitus type 2 in German Caucasians.  Horm Metab Res. 2006;  38 524-529
• 14 Fisher E. et al . Preliminary evidence of FABP2 A54 T polymorphism associated with reduced risk of type 2 diabetes and obesity in women from a German cohort.  Horm Metab Res. 2006;  38 341-345
• 15 Kiessling A, Ehrhart-Bornstein M. Transcription factor 7-like 2 (TCFL2) - a novel factor involved in pathogenesis of type 2 diabetes.  , Comment on: Grant et al. Nature Genetics 2006, Published online 15 January 2006. Horm Metab Res. 2006;  38 137-138
• 16 Hoffmann K. et al . A German genome-wide linkage scan for type 2 diabetes supports the existence of a metabolic syndrome locus on chromosome 1p36.13 and a type 2 diabetes locus on chromosome 16p12.2.  Diabetologia. 2007;  50 1418-1422
• 17 Tsuchiya T. et al . Association of the calpain-10 gene with type 2 diabetes in Europeans: results of pooled and meta-analyses.  Mol Genet Metab. 2006;  89 174-184
• 18 Trajkovski M. et al . Genes of type 2 diabetes in Beta cells.  Endocrinol Metab Clin North Am. 2006;  35 357-369
• 19 Schwarz PE. et al . Hypoadiponectinemia is associated with progression toward type 2 diabetes and genetic variation in the ADIPOQ gene promoter.  Diabetes Care. 2006;  29 1645-1650
• 20 Thamer C. et al . Beta cell function, insulin resistance and plasma adiponectin concentrations are predictors for the change of postprandial glucose in non-diabetic subjects at risk for type 2 diabetes.  Horm Metab Res. 2006;  38 178-182
• 21 Hiltunen LA. Does glucose tolerance affect elderly persons’ balance, gait or muscle strength?.  Cent Eur J Public Health. 2001;  9 22-25
• 22 Schutte AE, O’Dea K, Schwarz PE. Could statistical adjustments for age mask the insulin-blood pressure relationship?.  Diabetes Res Clin Pract. 2006;  72 104-107
• 23 Knowler WC. et al . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.  N Engl J Med. 2002;  346 393-403
• 24 Tuomilehto J. et al . Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.  N Engl J Med. 2001;  344 1343-1350
• 25 Chiasson JL. et al . Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial.  Lancet. 2002;  359 2072-2077
• 26 Pan XR. et al . Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study.  Diabetes Care. 1997;  20 537-544
• 27 American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases . The prevention or delay of type 2 diabetes.  Diabetes Care. 2002;  25 742-749
• 28 Lindstrom J. et al . Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study.  Lancet. 2006;  368 1673-1679
• 29 Ou HY. et al . Metformin increases insulin sensitivity and plasma beta-endorphin in human subjects.  Horm Metab Res. 2006;  38 106-111
• 30 Ramachandran A. et al . The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1).  Diabetologia. 2006;  49 289-297
• 31 Torgerson JS. et al . XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.  Diabetes Care. 2004;  27 155-161
• 32 Gerstein HC. et al . Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial.  Lancet. 2006;  368 1096-1105
• 33 Bosch J. et al . Effect of ramipril on the incidence of diabetes.  N Engl J Med. 2006;  355 1551-1562
• 34 Abuissa H. et al . Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for prevention of type 2 diabetes: a meta-analysis of randomized clinical trials.  J Am Coll Cardiol. 2005;  46 821-826
• 35 Chiasson JL, Brindisi MC, Rabasa-Lhoret R. The prevention of type 2 diabetes: what is the evidence?.  Minerva Endocrinol. 2005;  30 179-191
• 36 Watts G. Huge numbers must change lifestyle to prevent epidemic of diabetes.  BMJ. 2003;  327 1365
• 37 Narayan KM, Bowman BA, Engelgau ME. Prevention of type 2 diabetes.  BMJ. 2001;  323 63-64
• 38 Schwarz PE. et al . Development of a diabetes prevention management program for clinical practice.  Public Health Rep. 2007;  122 258-263
• 39 Schwarz PE. et al . Prevention of type 2 diabetes: what challenges do we have to address?.  J Pub Health. 2005;  13 296-303
• 40 Schwarz PE. Targeted diabetes prevention in high risk groups: pro.  Dtsch Med Wochenschr. 2005;  130 1103
• 41 Lindstrom J, Tuomilehto J. The Diabetes Risk Score: A practical tool to predict type 2 diabetes risk.  Diabetes Care. 2003;  26 725-731
• 42 Saaristo T. et al . Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome.  Diab Vasc Dis Res. 2005;  2 67-72
• 43 Schwarz PE. et al . Prevention of type 2 diabetes in Germany. Ideas, evidence, implementation.  Med Klin (Munich). 2006;  101 730-736
• 44 Sartorelli DS. et al . Primary prevention of type 2 diabetes through nutritional counseling.  Diabetes Care. 2004;  27 3019
• 45 Schwarz PE. et al . Diabetes prevention - from physiology to implementation.  Horm Metab Res. 2006;  38 460-464
• 46 Lindstrom J. et al . High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study.  Diabetologia. 2006;  49 912-920
• 47 Roubideaux Y. et al . Measuring the quality of diabetes care for older American Indians and Alaska natives.  Am J Public Health. 2004;  94 60-65
• 48 Schwarz PE. et al . Prevention of diabetes mellitus: The future of German diabetology.  Hamostaseologie. 2007;  27 13-21
• 49 Hadaegh F. et al . Waist/height ratio as a better predictor of type 2 diabetes compared to body mass index in Tehranian adult men - a 3.6-year prospective study.  Exp Clin Endocrinol Diabetes. 2006;  114 ((6)) 310-315
• 50 Wenying Y, Zhaojun Y. Obesity and hypertension as two anthropometric predictors for metabolic syndrome.  Horm Metab Res. 2006;  38 469-470
• 51 Hanefeld M. et al . The Metabolic Syndrome - A Postprandial Disease?.  Horm Metab Res. 2006;  38 435-436

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