Prevention of Type 2 Diabetes: Evidence and Strategies

The recently updated ADA guidelines recommend referring patients with prediabetes to an intensive diet and physical activity behavioral counseling program; diet and activity goals should adhere to the tenets of the DPP, with a loss of 7% of body weight and at least 150 minutes of moderate physical activity (eg, brisk walking) per week [8]. Metformin therapy for diabetes prevention should be considered in patients with prediabetes, especially in those with BMI greater than 35 kg/m ², those younger than 60 years of age, women with history of gestational diabetes, and/or those with rapidly rising A1C despite lifestyle modifications. Monitoring for development of diabetes, at least annually, and screening for and treatment of modifiable cardiovascular risk factors are suggested in patients with prediabetes [8].

Many lessons have been learned through the studies of diabetes prevention interventions. The challenge that remains is how to apply these interventions, especially the lifestyle modifications, in real world medical practice, at both the individual and public health level.

Corresponding author: Jocelyne Karam, MD, 4802 10th Avenue, Brooklyn, NY 11219, jkaram@maimonidesmed.org.

Financial disclosures: None reported.