Open AccessDiabetes prevention: is there more to it than lifestyle changes?
Author(s) -
Gruber A.,
Nasser K.,
Smith R.,
Sharma J. C.,
Thomson G. A.
Publication year - 2006
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/j.1368-5031.2006.00929.x
Subject(s) - medicine , number needed to treat , orlistat , diabetes mellitus , troglitazone , metformin , type 2 diabetes , weight loss , endocrinology , relative risk , obesity , confidence interval , peroxisome , receptor
Summary Over the past years, there has been an explosive increase in the prevalence of type 2 diabetes (T2DM) and this is expected to continue, entailing associated morbidity and mortality. An increasing number of studies explore the different ways T2DM could be prevented. On‐going lifestyle modifications need to be addressed. High‐risk patients should be given counselling on weight loss, possibly using a low glycaemic index diet, with a target of around 7–10% over 6–12 months, as well as instruction for increasing physical activity to around 150 min of physical exercise weekly (NNT = 4–8). Moderate alcohol consumption and coffee consumption may also be of benefit (NNT = 89 and 66, respectively). Metformin (NNT = 14), acarbose (NNT = 11) and troglitazone (NNT = 6) have been shown to prevent/delay T2DM and angiotensin‐converting enzyme (ACE) inhibitors and statins appear to have an adjunctive role (NNT = 42 and 112, respectively). Trials with orlistat and bariatric surgery have also prevented T2DM (NNT = 36 and 6, respectively), and forthcoming treatment with GLP1 mimetics appears promising. Diabetes prevention studies should help create well‐defined strategies for screening and treating high‐risk populations in the real world, as prevention is our only chance to alleviate the ever growing burden of diabetes mellitus in the world.