The major diabetes prevention trials
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Type 2 diabetes (T2D) is a devastating disease with multiple complications affecting many tissues, most notably the cardiovascular system. To be able to prevent a chronic disease such as T2D, certain requirements have to be met. Knowledge about its natural history with a preclinical phase, modifiable risk factors, effective and simple screening tools to identify high-risk subjects, and effective intervention that is affordable and acceptable are necessary. In addition, the efficacy of the intervention has to be proven under a clinical trial setting. Several major lifestyle intervention trials have been successfully carried out, with consistent results: the risk of T2D in high-risk subjects can be halved, the effect of lifestyle changes is rapid, and benefits are similar in different ethnic groups. Thus, the prevention of T2D is possible in most high-risk subjects, but how to achieve this at the population level remains a major challenge.
- Joslin E: The prevention of diabetes mellitus. JAMA 1921, 76:79–84.
- WHO Study Group: Primary Prevention of Diabetes Mellitus— Technical Report Series No 844. Geneva; 1994. Report No. 844.
- Kosaka K, Hagura R, Kuzuya T: Insulin responses in equivocal and definite diabetes, with special reference to subjects who had mild glucose intolerance but later developed definite diabetes. Diabetes 1977, 26:944–952.
- Ward WK, Beard JC, Halter JB, et al.: Pathophysiology of insulin secretion in non-insulin-dependent diabetes mellitus. Diabetes Care 1984, 7:491–502. CrossRef
- Bruce DG, Chisholm DJ, Storlien LH, et al.: Physiological importance of deficiency in early prandial insulin secretion in noninsulin-dependent diabetes. Diabetes 1988, 37:736–744. CrossRef
- Manson JE, Rimm EB, Stampfer MJ, et al.: Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991, 338:774–778. CrossRef
- Tuomilehto J, Tuomilehto-Wolf E, Zimmet P, et al.: Primary prevention of diabetes mellitus. In International Textbook of Diabetes Mellitus, edn 2. Edited by Alberti K, et al. Chichester, NY: John Wiley & Sons; 1997:1799–1827.
- Neel JV: Diabetes mellitus: a “thrifty” genotype rendered detrimental by progress? Am J Hum Genet 1962, 14:353–362.
- Kahn CR, Vicent D, Doria A: Genetics of non-insulin-dependent (type-II) diabetes mellitus. Annu Rev Med 1996, 47:509–531. CrossRef
- King H, Aubert RE, Herman WH: Global burden of diabetes, 1995-2025. Diabetes Care 1998, 21:1414–1431. CrossRef
- Hamman R: Prevention of Type 2 diabetes. In The Evidence for Diabetes Care. Edited by Williams R, et al. Chichester, NY: John Wiley & Sons; 2002:75–176. Extensive review of intervention studies aimed at reversing the deterioration of glucose tolerance. CrossRef
- Sartor G, Schersten B, Carlstrom S, et al.: Ten-year follow-up of subjects with impaired glucose tolerance. Prevention of diabetes by tolbutamide and diet regulation. Diabetes 1980, 29:41–49. CrossRef
- Eriksson KF, Lindgarde F: Prevention of type 2 (non-insulin- dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. Diabetologia 1991, 34:891–898. CrossRef
- Knowler W, Narayan K, Hanson R, et al.: Perspectives in Diabetes. Preventing non-insulin-dependent diabetes. Diabetes 1995, 44:483–488. CrossRef
- Pan XR, Li GW, Hu YH, 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. CrossRef
- Eriksson J, Lindström J, Valle T, et al.: Prevention of type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1- year interim report on the feasibility of the lifestyle intervention programme. Diabetologia 1999, 42:793–801. CrossRef
- Uusitupa M, Louheranta A, Lindström J, et al.: The Finnish Diabetes Prevention Study. Brit J Nutr 2000, 83:S137-S142.
- Tuomilehto J, Lindström J, Eriksson 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. The first controlled, individually randomized study to prove thatT2D is preventable by lifestyle intervention. CrossRef
- The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes [no authors listed]. Diabetes Care 1999, 22:623–634.
- Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin [no authors listed]. N Engl J Med 2002, 346:393–403. A large intervention study that confirmed the findings from the DPS and demonstrated the effectiveness of a lifestyle intervention also in different ethnic and age groups.
- The Diabetes Prevention Program (DPP). Description of lifestyle intervention [no authors listed]. Diabetes Care 2002, 25:2165–2171.
- Chiasson J-L, Josse RG, Gomis R, et al.: Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002, 359:2072–2077. CrossRef
- Chiasson JL, Gomis R, Hanefeld M, et al.: The STOP-NIDDM Trial: an international study on the efficacy of an alpha-glucosi- dase inhibitor to prevent type 2 diabetes in a population with impaired glucose tolerance: rationale, design, and preliminary screening data. Study to Prevent Non-Insulin-Dependent Diabetes Mellitus. Diabetes Care 1998, 21:1720–1725. CrossRef
- Azen SP, Peters RK, Berkowitz K, et al.: TRIPOD (TRoglitazone In the Prevention Of Diabetes): a randomized, placebo-controlled trial of troglitazone in women with prior gestational diabetes mellitus. Control Clin Trials 1998, 19:217–231. CrossRef
- Buchanan TA, Xiang AH, Peters RK, et al.: Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high- risk Hispanic women. Diabetes 2002, 51:2796–2803. CrossRef
- Kjos SL, Peters RK, Xiang A, et al.: Predicting future diabetes in Latino women with gestational diabetes. Utility of early post- partum glucose tolerance testing. Diabetes 1995, 44:586–591. CrossRef
- Dyson PA, Hammersley MS, Morris RJ, et al.: The Fasting Hyperglycaemia Study: II. Randomized controlled trial of reinforced healthy-living advice in subjects with increased but not diabetic fasting plasma glucose. Metabolism 1997, 46:50–55. CrossRef
- Shaw JE, Zimmet PZ, de Courten M, et al.: Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care 1999, 22:399–402. CrossRef
- Yang W, Lin L, Yu Z, et al.: The preventive affect of acarbose and metformin on the progression to diabetes mellitus in the IGT population: a 3-year multicenter prospective study. Chin J Endocrinol Metab 2001, 17:131–136.
- Tataranni PA, Bogardus C: Changing habits to delay diabetes. N Engl J Med 2001, 344:1390–1392. CrossRef
- Sjöström CD, Lissner L, Wedel H, et al.: Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res 1999, 7:477–484.
- Sjöström L, Torgerson JS, Hauptman J, et al.: XENDOS (XENical in the prevention of Diabetes in the Obese Subjects): a landmark study. Paper presented at the 9th International Congress on Obesity. Sao Paulo, Brazil, 2002.
- Dabelea D, Hanson RL, Bennett PH, et al.: Increasing prevalence of type II diabetes in American Indian children. Diabetologia 1998, 41:904–910. CrossRef
- Ehtisham S, Barrett TG, Shaw NJ: Type 2 diabetes mellitus in UK children—an emerging problem. Diabet Med 2000, 17:867–871. CrossRef
- Sinha R, Fisch G, Teague B, et al.: Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002, 346:802–810. CrossRef
- Invitti C, Guzzaloni G, Gilardini L, et al.: Prevalence and concomitants of glucose intolerance in european obese children and adolescents. Diabetes Care 2003, 26:118–124. CrossRef
- Dabelea D, Pettitt DJ, Hanson RL, et al.: Birth weight, type 2 diabetes, and insulin resistance in Pima Indian children and young adults. Diabetes Care 1999, 22:944–950. CrossRef
- Forsén T, Eriksson J, Tuomilehto J, et al.: The fetal and childhood growth of persons who develop type 2 diabetes. Ann Intern Med 2000, 133:176–182.
- Lindstrom J, Tuomilehto J: The Diabetes Risk Score. A practical tool to predict type 2 diabetes risk. Diabetes Care 2003, in press.
- Finnish Diabetes Association: Development programme for the prevention and care of diabetes in Finland 2000-2010. http://www.diabetes.fi/english/programme/. Accessed on October 30, 2002.
- The major diabetes prevention trials
Current Diabetes Reports
Volume 3, Issue 2 , pp 115-122
- Cover Date
- Print ISSN
- Online ISSN
- Current Medicine Group
- Additional Links