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The prevention of type 2 diabetes Crandall JP; Knowler WC; Kahn SE; Marrero D; Florez JC; Bray GA; Haffner SM; Hoskin M; Nathan DMNat Clin Pract Endocrinol Metab 2008[Jul]; 4 (7): 382-93Type 2 diabetes mellitus (T2DM) affects more than 7% of adults in the US and leads to substantial personal and economic burden. In prediabetic states insulin secretion and action--potential targets of preventive interventions--are impaired. In trials lifestyle modification (i.e. weight loss and exercise) has proven effective in preventing incident T2DM in high-risk groups, although weight loss has the greatest effect. Various medications (e.g. metformin, thiazolidinediones and acarbose) can also prevent or delay T2DM. Whether diabetes-prevention strategies also ultimately prevent the development of diabetic vascular complications is unknown, but cardiovascular risk factors are favorably affected. Preventive strategies that can be implemented in routine clinical settings have been developed and evaluated. Widespread application has, however, been limited by local financial considerations, even though cost-effectiveness might be achieved at the population level.|Diabetes Mellitus, Type 2/*prevention & control[MESH]|Humans[MESH]|Hypoglycemic Agents/*therapeutic use[MESH]|Life Style[MESH]|Prediabetic State/drug therapy/*therapy[MESH] |
