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Type 2 Diabetes Prevention

Prevention Of Type 2 Diabetes By Lifestyle Intervention In An Australian Primary Health Care Setting: Greater Green Triangle (ggt) Diabetes Prevention Project

Prevention Of Type 2 Diabetes By Lifestyle Intervention In An Australian Primary Health Care Setting: Greater Green Triangle (ggt) Diabetes Prevention Project

Abstract Randomised controlled trials demonstrate a 60% reduction in type 2 diabetes incidence through lifestyle modification programmes. The aim of this study is to determine whether such programmes are feasible in primary health care. An intervention study including 237 individuals 40–75 years of age with moderate or high risk of developing type 2 diabetes. A structured group programme with six 90 minute sessions delivered during an eight month period by trained nurses in Australian primary health care in 2004–2006. Main outcome measures taken at baseline, three, and 12 months included weight, height, waist circumference, fasting plasma glucose and lipids, plasma glucose two hours after oral glucose challenge, blood pressure, measures of psychological distress and general health outcomes. To test differences between baseline and follow-up, paired t-tests and Wilcoxon rank sum tests were performed. At twelve months participants' mean weight reduced by 2.52 kg (95% confidence interval 1.85 to 3.19) and waist circumference by 4.17 cm (3.48 to 4.87). Mean fasting glucose reduced by 0.14 mmol/l (0.07 to 0.20), plasma glucose two hours after oral glucose challenge by 0.58 mmol/l (0.36 to 0.79), total cholesterol by 0.29 mmol/l (0.18 to 0.40), low density lipoprotein cholesterol by 0.25 mmol/l (0.16 to 0.34), triglycerides by 0.15 mmol/l (0.05 to 0.24) and diastolic blood pressure by 2.14 mmHg (0.94 to 3.33). Significant improvements were also found in most psychological measures. This study provides evidence that a type 2 diabetes prevention programme using lifestyle intervention is feasible in primary health care settings, with reductions in risk factors approaching those observed in clinical trials. Background It is widely recognised that the incidence of type 2 diabe Continue reading >>

Type 2 Diabetes Prevention In The “real World”

Type 2 Diabetes Prevention In The “real World”

Abstract OBJECTIVE—“Real-world” implementation of lifestyle interventions is a challenge. The Good Ageing in Lahti Region (GOAL) Lifestyle Implementation Trial was designed for the primary health care setting, with lifestyle and risk reduction objectives derived from the major diabetes prevention efficacy trials. We report on the program's effectiveness as well as findings related to the program's reach, adoption, and implementation. RESEARCH DESIGN AND METHODS—A total of 352 middle-aged participants with elevated type 2 diabetes risk were recruited from the health care centers in Päijät-Häme Province in Finland. The intervention included six group counseling sessions, delivered by trained public health nurses. Measurement was conducted at baseline and 12 months. Clinical risk factors were measured by study nurses, and lifestyle outcomes were analyzed from self-reports. Lifestyle outcomes were compared with the outcomes achieved in relevant efficacy trials, and within-subject changes were tested for risk reduction. RESULTS—At baseline, mean BMI was >32 kg/m2, and 25% of the participants had impaired glucose tolerance. At 12 months, 20% of participants achieved at least four of five key lifestyle outcomes, with these results being comparable with the reference trials. However, physical activity and weight loss goals were achieved significantly less frequently (65 vs. 86% and 12 vs. 43%, respectively). Several clinical risk factors decreased, more so among men than women. CONCLUSIONS—This trial demonstrates that lifestyle counseling can be effective and is feasible in real-world settings for individuals with elevated risk of type 2 diabetes. To increase program impact, program exposure and treatment intensity need to be increased. RESEARCH DESIGN AND METHOD Continue reading >>

Preventing Type 2 Diabetes In At-risk Patients

Preventing Type 2 Diabetes In At-risk Patients

Many physicians now spend less time delivering direct patient care. This is primarily due to increasing administrative responsibilities that are a result of regulatory pressures along with evolving payment and care delivery models. In the average primary care practice, up to one‑third of patients age 18 and above – and up to half age 65 and above – could be at risk for prediabetes. Physicians and their care teams play an important role in diabetes prevention. Preventing type 2 diabetes in at‑risk patients Release Date: June 2015 End Date: June 2019 At the end of this activity, participants will be able to: Define the medical condition of prediabetes and treatment options for prediabetes Identify patients with prediabetes Educate patients at‑risk for type 2 diabetes Determine roles and responsibilities regarding diabetes prevention and practice workflow Refer patients with prediabetes to an evidence‑based diabetes prevention program This activity is designed to meet the educational needs of practicing physicians and their care teams. Eighty‑six million adults in the United States have prediabetes, but 90 percent of them are undiagnosed.1 Up to 30 percent of people with prediabetes will develop diabetes within five years.2‑3 People with prediabetes also have an increased risk of heart disease and stroke.1 Early and intensive lifestyle intervention can prevent or delay diabetes in at‑risk patients2‑17 and has also demonstrated secondary prevention of microvascular and macrovascular complications. Physicians and their care teams play an important role in diabetes prevention. This diabetes prevention module presents strategies to help physicians as well as practice staff educate patients about their risk for developing diabetes and refer at‑risk patient Continue reading >>

Prevention Of Diabetes Mellitus

Prevention Of Diabetes Mellitus

Tweet When people talk about prevention of diabetes, it is usually about preventing type 2 diabetes. In the majority of cases, type 2 diabetes is brought on by lifestyle factors which can often be prevented. These include an unbalanced diet, lack of activity, lack of sleep, stress, smoking and alcohol. By making lifestyles changes, you can decrease your risk of developing type 2 diabetes. Type 2 diabetes prevention overview Leading doctors and researchers point to excessive levels of insulin as the likely reason why insulin resistance and type 2 diabetes develops. Strategies such as low-carb diets and exercise help to reduce levels of insulin and are therefore effective for preventing type 2 diabetes from developing. There are a number of risk factors for diabetes, some of which are preventable, such as weight gain around the middle (central obesity), high cholesterol/triglyceride levels and high blood pressure. Losing weight, adopting more activity into your day, stopping smoking and reducing alcohol intake can also help towards lowering the risk of developing type 2 diabetes mellitus and improving your all-round health. Diet and preventing type 2 diabetes Diet is the most important part of lifestyle change. The adage that you can’t outrun a bad diet is true. It is much easier to lose weight on a good diet even if you are struggling to do exercise, than it is through exercise if you’re eating a poor diet. Effective diets to prevent type 2 diabetes are those that do not cause your body to produce a lot of insulin. Carbohydrate has the biggest demand on insulin and so any diet that helps reduce carbohydrate intake will help towards reducing your risk of type 2 diabetes. Cutting out sugary food and drink and refined grains such as white bread and white rice is a good Continue reading >>

Prevention Of Type 2 Diabetes Mellitus By Changes In Lifestyle Among Subjects With Impaired Glucose Tolerance

Prevention Of Type 2 Diabetes Mellitus By Changes In Lifestyle Among Subjects With Impaired Glucose Tolerance

Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known. We randomly assigned 522 middle-aged, overweight subjects (172 men and 350 women; mean age, 55 years; mean body-mass index [weight in kilograms divided by the square of the height in meters], 31) with impaired glucose tolerance to either the intervention group or the control group. Each subject in the intervention group received individualized counseling aimed at reducing weight, total intake of fat, and intake of saturated fat and increasing intake of fiber and physical activity. An oral glucose-tolerance test was performed annually; the diagnosis of diabetes was confirmed by a second test. The mean duration of follow-up was 3.2 years. The mean (±SD) amount of weight lost between base line and the end of year 1 was 4.2±5.1 kg in the intervention group and 0.8±3.7 kg in the control group; the net loss by the end of year 2 was 3.5±5.5 kg in the intervention group and 0.8±4.4 kg in the control group (P<0.001 for both comparisons between the groups). The cumulative incidence of diabetes after four years was 11 percent (95 percent confidence interval, 6 to 15 percent) in the intervention group and 23 percent (95 percent confidence interval, 17 to 29 percent) in the control group. During the trial, the risk of diabetes was reduced by 58 percent (P<0.001) in the intervention group. The reduction in the incidence of diabetes was directly associated with changes in lifestyle. Continue reading >>

4. Prevention Or Delay Of Type 2 Diabetes

4. Prevention Or Delay Of Type 2 Diabetes

Patients with prediabetes should be referred to an intensive diet and physical activity behavioral counseling program adhering to the tenets of the Diabetes Prevention Program (DPP) targeting a loss of 7% of body weight and should increase their moderate-intensity physical activity (such as brisk walking) to at least 150 min/week. A Follow-up counseling and maintenance programs should be offered for long-term success in preventing diabetes. B Based on the cost-effectiveness of diabetes prevention, such programs should be covered by third-party payers. B Metformin therapy for prevention of type 2 diabetes should be considered in those with prediabetes, especially in those with BMI >35 kg/m2, those aged <60 years, and women with prior gestational diabetes mellitus. A At least annual monitoring for the development of diabetes in those with prediabetes is suggested. E Screening for and treatment of modifiable risk factors for cardiovascular disease is suggested. B Diabetes self-management education and support programs are appropriate venues for people with prediabetes to receive education and support to develop and maintain behaviors that can prevent or delay the onset of diabetes. B Technology-assisted tools including Internet-based social networks, distance learning, DVD-based content, and mobile applications can be useful elements of effective lifestyle modification to prevent diabetes. B Lifestyle Modification Randomized controlled trials have shown that individuals at high risk for developing type 2 diabetes (impaired fasting glucose, impaired glucose tolerance, or both) can significantly decrease the rate of diabetes onset with particular interventions (1–7). These include intensive lifestyle modification programs that have been shown to be very effective (∼58% r Continue reading >>

Type 2 Diabetes Prevention In The Real World

Type 2 Diabetes Prevention In The Real World

Three-year results of the GOAL Lifestyle Implementation Trial Abstract OBJECTIVE We study the effectiveness of the GOAL Lifestyle Implementation Trial at the 36-month follow-up. RESEARCH DESIGN AND METHODS Participants (n = 352, type 2 diabetes risk score FINDRISC = 16.2 ± 3.3, BMI 32.6 ± 5.0 kg/m2) received six lifestyle counseling sessions over 8 months. Measurements were at baseline, 12 months (88.6%), and 36 months (77.0%). RESULTS Statistically significant risk reduction at 12 months was maintained at 36 months in weight (−1.0 ± 5.6 kg), BMI (−0.5 ± 2.1 kg/m2), and serum total cholesterol (−0.4 ± 1.1 mmol/l). CONCLUSIONS Maintenance of risk reduction in this “real world” trial proves the intervention's potential for significant public health impact. The Goal Lifestyle Implementation Trial (1,2) replicated most of the findings from the Finnish Diabetes Prevention Study (DPS) (3,4) in primary health care settings, demonstrating that lifestyle counseling can be effective and feasible in routine care. We report findings on sustainability of the results at 3 years. RESEARCH DESIGN AND METHODS This study was developed and evaluated as a “real world” implementation trial (5). We analyze risk factor changes from baseline to 3-year follow-up. The intervention, with lifestyle change objectives drawn from the DPS (3), was delivered as six sessions of task-oriented sociobehavioral group counseling by public health nurses over a period of 8 months. The protocol included no other formal postintervention contact with the participants, except follow-up measurements at years 1 and 3. A fully detailed description of the program content, recruitment, participant characteristics, and measures has been published previously (1). The study sample consisted of 352 parti Continue reading >>

Prevention Of Diabetes Mellitus Type 2

Prevention Of Diabetes Mellitus Type 2

Main article: Diabetes mellitus type 2 Prevention of diabetes mellitus type 2 can be achieved with both lifestyle changes and use of medication.[1] The American Diabetes Association categorizes prediabetes as a high-risk group that has glycemic levels higher than normal but does not meet criteria for diabetes. Without intervention people with prediabetes progress to type 2 diabetes with a 5% to 10% rate. Diabetes prevention is achieved through weight loss and increased physical activity, which can reduce the risk of diabetes by 50% to 60%.[2] Lifestyle[edit] Many interventions to promote healthy lifestyles have been shown to prevent diabetes. A combination of diet and physical activity promotion through counselling and support programs decrease weight, improve systolic blood pressure, improve cholesterol levels and decrease risk of diabetes.[2] Increasing physical activity may be helpful in preventing type 2 diabetes, particularly if undertaken soon after a carbohydrate rich meal that increases blood sugar levels.[3][4][5] The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake (around 30% of energy supply should come from fat), and eating sufficient fiber (e.g., from whole grains). Some preliminary evidence suggests that resistant starch, used as a substitute for refined carbohydrate, may increase insulin sensitivity[6] and may reduce the risk of type 2 diabetes.[7] The U.S. Food and Drug Administration requires claims that resistant starch can reduce the risk of type 2 diabetes to be qualified with a declaration that scientific evidence in support of this claim is limited.[8] Foods with low glycemic index rich in fiber Continue reading >>

Prevention Of Type 2 Diabetes

Prevention Of Type 2 Diabetes

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also separate Diabetes Education and Self-management Programmes, Gestational Diabetes, Metabolic Syndrome (insulin resistance), Managing Impaired Glucose Tolerance in Primary Care articles. Although effective treatment of diabetes mellitus can reduce the incidence of its complications, type 2 diabetes is more often than not an asymptomatic condition and many people with type 2 diabetes have macrovascular and microvascular complications by the time their condition is diagnosed. Factors which influence someone's risk of type 2 diabetes include being overweight, high waist circumference, increasing age, low level of physical activity and whether or not they have a previous history of gestational diabetes or a family history of type 2 diabetes.[1] Glycated haemoglobin (HbA1c) levels of 48 mmol/mol (6.5%) or above indicate that someone has type 2 diabetes. It has been recommended by a UK expert group that HbA1c values between 42 and 47 mmol/mol (6.0-6.4%) indicate that a person is at high risk of type 2 diabetes. There is a continuum of risk across a range of sub-diabetic HbA1c levels and people with an HbA1c below 42 mmol/mol (6.0%) may also be at risk. Recent National Institute for Health and Care Excellence (NICE) guidance has recommended:[2] Identifying people at risk of developing type 2 diabetes, using a validated risk assessment score and a blood test (fasting blood glucose or HbA1c) to confirm high risk. Providing those at high risk with an intensi Continue reading >>

Prediabetes

Prediabetes

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 84 million American adults—more than 1 out of 3—have prediabetes. Of those with prediabetes, 90% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke. The good news is that if you have prediabetes, the CDC-led National Diabetes Prevention Program can help you make lifestyle changes to prevent or delay type 2 diabetes and other serious health problems. Causes Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road. Symptoms & Risk Factors You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems such as type 2 diabetes show up. It’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include: Being overweight Being 45 years or older Having a parent, brother, or sister with type 2 diabetes Being physically active less than 3 times a week Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby who weighed more than 9 pounds Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk. Getting Tested You can get a simple blood Continue reading >>

Type 2 Diabetes: Prevention And Cure?

Type 2 Diabetes: Prevention And Cure?

General practice in the UK has been very successful in meeting the challenges raised by increasing prevalence of diabetes. Most diabetes is now managed in general practice and disease registers, evidencebased care, diabetes clinics, and diabetes trained practice nurses are now routine. As a consequence of the obesity epidemic, and the ageing population, diabetes rates are rising, and diabetes can remain undiagnosed for many years. GPs have made progress in recent years in identifying previously undiagnosed cases. Recent population-based reports suggest that only 3% of men and 1% of women over 50 years have undiagnosed diabetes.1 PREVENTION However, many more people are at high risk of developing diabetes (16% of people aged over 60 years have impaired fasting glucose),2 and detecting these people is important because it has been shown that type 2 diabetes can be prevented in a costeffective fashion in people at high risk by weight loss secondary to alteration in diet and exercise.3 There are major problems in translating this research success into everyday practice, chief among these are how to identify people with undiagnosed diabetes or at high risk; and how to intervene once they have been identified. Screening for diabetes is currently not cost-effective,4 although focused case finding has been advocated for some time. The efficiency of looking for diabetes can be greatly improved by initial use of risk scores. Both the Leicester and the Cambridge risk scores can be run on routinely collected data in computerised databases. These scores identify who within the population is at high enough risk to warrant a blood test for diabetes. But the question is how to get these blood tests done? The framework of the NHS Health Check Programme5 provided the perfect solution to Continue reading >>

Preventing Type 2 Diabetes In Adults

Preventing Type 2 Diabetes In Adults

NYU Langone doctors work with people of all ages to help them prevent type 2 diabetes, a serious condition in which a person has chronically high levels of blood glucose, or sugar. Type 2 diabetes is one of the fastest growing diseases in the United States. Since 2010, the number of people in the U.S. who have diabetes has grown to more than 29 million people. Type 2 diabetes is also on the rise in children and adolescents. Normally, the body breaks down the sugars and starches in food into glucose. As glucose levels rise in the bloodstream, the pancreas responds by making insulin—a hormone that signals the body to use and store glucose to supply cells with energy. In people with type 2 diabetes, the body is less responsive to insulin, and the pancreas can’t make enough of the hormone to prevent blood sugar levels from rising. This causes a buildup of glucose in the blood. When there’s too much sugar in the blood, cells can’t function properly. Just as rust can eventually damage your car, high blood sugar levels can lead to widespread blood vessel and nerve damage. Over time, elevated blood sugar levels can injure organs and tissues throughout the body, such as the heart, kidneys, eyes, and feet. Get Screened Your doctor may screen for type 2 diabetes during your regular checkup. Depending on your risk of developing this condition, your doctor may recommend screening every three years or more often. Screening is performed with a fasting blood sugar test. This test measures blood sugar levels after you’ve fasted for several hours, usually overnight. Doctors can also use a hemoglobin A1C blood test—which measures blood sugar levels over a two- or three-month period—to screen for type 2 diabetes. The American Diabetes Association recommends screening for type Continue reading >>

Simple Steps To Preventing Diabetes

Simple Steps To Preventing Diabetes

Table of Contents Simple Steps to Lower Your Risk Introduction If type 2 diabetes was an infectious disease, passed from one person to another, public health officials would say we’re in the midst of an epidemic. This difficult disease, once called adult-onset diabetes, is striking an ever-growing number of adults. Even more alarming, it’s now beginning to show up in teenagers and children. More than 24 million Americans have diabetes; of those, about 6 million don’t know they have the disease. (1) In 2007, diabetes cost the U.S. an estimated $116 billion in excess medical spending, and an additional $58 billion in reduced productivity. (1) If the spread of type 2 diabetes continues at its present rate, the number of people diagnosed with diabetes in the United States will increase from about 16 million in 2005 to 48 million in 2050. (2) Worldwide, the number of adults with diabetes will rise from 285 million in 2010 to 439 million in the year 2030. (3) The problems behind the numbers are even more alarming. Diabetes is the leading cause of blindness and kidney failure among adults. It causes mild to severe nerve damage that, coupled with diabetes-related circulation problems, often leads to the loss of a leg or foot. Diabetes significantly increases the risk of heart disease. And it’s the seventh leading cause of death in the U.S., directly causing almost 70,000 deaths each year and contributing to thousands more. (4) The good news is that type 2 diabetes is largely preventable. About 9 cases in 10 could be avoided by taking several simple steps: keeping weight under control, exercising more, eating a healthy diet, and not smoking. What Is Type 2 Diabetes? Our cells depend on a single simple sugar, glucose, for most of their energy needs. That’s why the body Continue reading >>

Podcast: Type 2 Diabetes Prevention And Management

Podcast: Type 2 Diabetes Prevention And Management

Patrick Sheehan is a recent graduate of Dartmouth College, where he focused his studies on Biomedical Engineering. From a young age, Patrick’s father, Dr. Peter Sheehan, a pioneer of T2D prevention and management, actively engaged him in his work in addressing the crisis relating to diabetes, its complications, and obesity. While finishing up his third year of college, his father’s sudden passing sparked his dedication to continue his father’s legacy, by co-founding the Peter Sheehan Diabetes Care Foundation. Working alongside his mother and many of his father’s former colleagues, Patrick is passionate about promoting his father’s philosophy, that prevention is the best approach to curbing the diabetes epidemic. Dr. Peter Sheehan, MD Short bio about PSDCF: The Peter Sheehan Diabetes Care Foundation seeks to reduce the incidence of T2D, while improving the lives of those already afflicted with the disease. We seek to improve T2D care and prevention for at-risk populations, educate communities to prevent the onset of T2D and the complications, and organize forums for scientific ideas exchange to further the understanding of T2D. PSDCF is passionate about taking on the global T2D epidemic, by empowering communities with the necessary tools to manage and improve their health. PSDCF current activities: • Sheehan Population Health Initiative: ◦ projects in Chinatown NYC (our initial project), Seneca Nation, Jamaica, Russia ◦ We are partnering with University of Buffalo Center for Integrated Global Health Sciences and SUNY Global Health Institute to provide data analytical support ◦ Purpose: PSDCF works with culturally competent clinics in order to effectively deliver patient-centered health care services that meet the social, cultural, and linguistic needs o Continue reading >>

5 Ways To Prevent Prediabetes From Becoming Diabetes

5 Ways To Prevent Prediabetes From Becoming Diabetes

Prediabetes, or elevated blood sugar, puts you at high risk of developing type 2 diabetes, especially if you are overweight, but you can take steps to prevent it. Type 2 diabetes is not inevitable. More than 86 million American adults—approximately one-third of those over age 18 and half of those over 65—have prediabetes, and most of them don’t even know it. If you have prediabetes, it means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. Prediabetes puts you at higher-than-normal risk of developing type 2 diabetes, heart disease, and stroke. According to U.S. Centers for Disease Control, up to 30% of overweight men and women with prediabetes will develop type 2 diabetes within five years of diagnosis. You don’t have to be one of them! Here are five steps you can take to reduce your diabetes risk. Welcome to the Type 2 Diabetes Center! This is your launching pad for living better with type 2 diabetes. We’ve gathered all the latest type 2 diabetes information, research updates, and advances in devices and medications. And because diabetes impacts every facet of your life, you’ll also find practical advice from leading experts and other people living with type 2 diabetes featured here. That includes mouth-watering, healthy recipes; money-saving tips; advice to help navigate social, professional, and relationship issues; and inspiring personal stories from people just like you. Explore the resources here and be sure to subscribe to our newsletter to be alerted to new additions. Continue reading >>

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