Skip to main content

Advertisement

Log in

Prevention of type 2 diabetes: An update

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

With the rising tide of the diabetes epidemic leading to increased morbidity and mortality (primarily from cardiovascular disease), together with failure to control the disease and its associated complications, prevention of diabetes appears to be the logical option for curbing this epidemic. Several trials have been completed, and others ongoing, using various strategies for diabetes prevention. In this review, we provide an update on diabetes prevention strategies, highlighting the rationale behind such interventions, together with an outlook of the ongoing efforts that are likely to provide additional options for patients at risk for diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. World Health Organization: Diabetes (Fact Sheet No 312; September 2006). Available at http://www.who.int/mediacentre/ factsheets/fs312/en/. Accessed December 22, 2006.

  2. National Center for Health Statistics, Centers for Disease Control and Prevention: 1999–2003 National Health Interview Survey (NHIS), National Diabetes Fact Sheet 2005. Available at http://www.cdc.gov/nchs/nhis.htm. Accessed December 22, 2006.

  3. Wild S, Roglic G, Green A, et al.: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004, 27:1047–1053.

    Article  PubMed  Google Scholar 

  4. McFarlane SI, Shin J, Rundek T, et al.: Prevention of type 2 diabetes. Curr Diab Rep 2003, 3:235–241.

    Article  PubMed  Google Scholar 

  5. Dormandy J, Charbonnel B, Eckland D, et al.: Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitazone Clinical Trial in macrovascular Events): a randomized controlled trial. Lancet 2005, 366:1279–1289.

    Article  PubMed  CAS  Google Scholar 

  6. McFarlane SI, Jacober SJ, Winer N, et al.: Control of cardiovascular risk factors in patients with diabetes and hypertension at urban academic medical centers. Diabetes Care 2002, 25:718–723.

    Article  PubMed  Google Scholar 

  7. McFarlane SI, Sowers JR: Gender disparities in the control of cardiovascular risk factors in people with diabetes. J Clin Hypertens (Greenwich) 2005, 7:383–385.

    Article  Google Scholar 

  8. Saydah SH, Fradkin J, Cowie CC: Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 2004, 291:335–342.

    Article  PubMed  CAS  Google Scholar 

  9. Department of Health and Human Services, Centers for Disease Control and Prevention: Preventing Diabetes and Its Complications. Available at http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/diabetes.htm. Accessed December 22, 2006.

  10. American Diabetes Association: Economic costs of diabetes in the U.S. in 2002. Diabetes Care 2003, 26:917–932.

    Article  Google Scholar 

  11. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis of Diagnostic criteria in Europe [no authors listed]. Lancet 1999, 354:617–621.

  12. Hu FB, Stampfer MJ, Haffner SM, et al.: Elevated risk of cardiovascular disease prior to clinical diagnosis of type 2 diabetes. Diabetes Care 2002, 25:1129–1134.

    Article  PubMed  Google Scholar 

  13. Califf RM: Insulin resistance: a global epidemic in need of effective therapies. Eur Heart J Suppl 2003, 5(suppl C):C13–C18.

    Article  Google Scholar 

  14. Mokdad AH, Ford ES, Bowman BA, et al.: Prevalence of obesity, diabetes, and obesity-related health risk factors 2001. JAMA 2003, 289:76–79.

    Article  PubMed  Google Scholar 

  15. Sowers JR, Epstein M, Frolich ED: Diabetes, hypertension and cardiovascular disease: an update. Hypertension 2001, 37:1053–1059.

    PubMed  CAS  Google Scholar 

  16. Hussain A, Claussen B, Ramachandran A, et al.: Prevention of type 2 diabetes: a review. Diabetes Res Clin Pract 2006, Oct 25; [Epub ahead of print].

  17. Tuomilehto J, Lindstrom J, Eriksson JG, 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.

    Article  PubMed  CAS  Google Scholar 

  18. Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    Article  PubMed  CAS  Google Scholar 

  19. Eriksson KF, Lindgarde F: Prevention of type 2 (noninsulin-dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. Diabetologia 1991, 34:891–898.

    Article  PubMed  CAS  Google Scholar 

  20. 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.

    Article  PubMed  CAS  Google Scholar 

  21. Long SD, O’Brien K, MacDonald KG Jr, et al.: Weight loss in severely obese subjects prevents the prevention of impaired glucose tolerance test to type II diabetes. A longitudinal interventional study. Diabetes care 1994, 17:372–375.

    Article  PubMed  CAS  Google Scholar 

  22. Devlin JT: Effects of exercise on insulin sensitivity in humans. Diabetes Care 1992, 15:1690–1693.

    Article  PubMed  CAS  Google Scholar 

  23. Kirpichnikov D, McFarlane SI, Sowers J: Metformin: an update. Ann Intern Med 2002, 137:25–33.

    PubMed  CAS  Google Scholar 

  24. Zinman B, Harris SB, Gerstein HC, et al.: Preventing type 2 diabetes using combination therapy: design and methods of the Canadian Normoglycaemia Outcomes Evaluation (CANOE) trial. Diabetes Obes Metab 2006, 8:531–537.

    Article  PubMed  CAS  Google Scholar 

  25. El Atat F, Nicasio J, Clarke L, et al.: Beneficial cardiovascular effects of thiazolidinediones. Therapy 2005, 2:113–119.

    Article  Google Scholar 

  26. Buchanon A, Xiang A, Peters R, 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.

    Article  Google Scholar 

  27. DREAM Trial Investigators: Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial. Lancet 2006, 368:1096–1105.

    Article  Google Scholar 

  28. ClinicalTrials.gov: Actos Now for Prevention of Diabetes (ACT NOW). Available at http://www.clinicaltrials.gov/ct/show/NCT00220961?order=1. Accessed December 27, 2006.

  29. Chiasson JL, Josse RG, Leiter LA, et al.: The effect of acarbose on insulin sensitivity in subjects with impaired glucose tolerance. Diabetes Care 1996, 19:1191–1194.

    Article  Google Scholar 

  30. Chiasson JL, Josse RG, Gomis R, et al.: Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002, 359:2072–2077.

    Article  PubMed  CAS  Google Scholar 

  31. Van de Laar FA, Lucassen PL, Akkermans RP, et al.: Alphaglucosidase inhibitors for people with impaired glucose tolerance or impaired fasting blood glucose. Cochrane Database Syst Rev 2006, 4:CD005061.

    PubMed  Google Scholar 

  32. Sato Y, Nishikawa M, Shinkai H, Sukegawa E.: Possibility of ideal blood glucose control by a new oral hypoglycemic agent, N-[(trans-4-isopropylcyclohexyl)-carbonyl]-D-phenylalanine (A-4166), and its stimulatory effect on insulin secretion in animals. Diabetes Res Clin Prac 1991, 12:53–59.

    Article  CAS  Google Scholar 

  33. The NAVIGATOR Trial Steering Committee: Nateglinide and Valsartan in impaired glucose tolerance outcomes research, rationale and design of the Navigator Trial [abstract]. Diabetes 2002, 51(suppl 2):A116.

    Google Scholar 

  34. Yusuf S, Gerstein H, Hoogwerf B, et al.: Ramipril and the development of diabetes. JAMA 2001, 286:1882–1885.

    Article  PubMed  CAS  Google Scholar 

  35. Hansson L, Lindholm LH, Niskanen L, et al.: Effect of angiotensin-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomized trial. Lancet 1999, 353:611–616.

    Article  PubMed  CAS  Google Scholar 

  36. ALLHAT Officers and coordinators for the ALLHAT Collaborative Research Group: Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002, 288:2981–2997.

    Article  Google Scholar 

  37. Dahlof B, Devereux RB, Kjeldsen SE, et al.: Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002, 359:1004–1010.

    Article  PubMed  Google Scholar 

  38. Gillespie EL, White CM, Kardas M, et al.: The impact of ACE inhibitors or angiotensin II type 1 receptor blockers on the development of new-onset type 2 diabetes. Diabetes Care 2005, 28:2261–2266.

    Article  PubMed  CAS  Google Scholar 

  39. DREAM Trial Investigators: Effect of ramipril on the incidence of diabetes. N Engl J Med 2006, 355:1551–1561.

    Article  Google Scholar 

  40. Teo K, Yusuf S, Sleight P, et al.: Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCED) trials. Am Heart J 2004, 148:52–61.

    Article  PubMed  Google Scholar 

  41. McFarlane SI, Kumar A, Sowers JR: Mechanisms by which angiotensin-converting enzyme inhibitors prevent diabetes and cardiovascular disease. Am J Cardiol 2003, 91:H30–H37

    Article  Google Scholar 

  42. Henriken EJ, Jacob S: Modulation of metabolic control by angiotensin converting enzyme (ACE) inhibition. J Cell Physiol 2003, 196:171–179.

    Article  Google Scholar 

  43. Carlsson PO, Berne C, Jansson L: Angiotensin II and the endocrine pancreas: effects on islet blood flow and insulin secretion in rats. Diabetologia 1998, 41:127–133.

    Article  PubMed  CAS  Google Scholar 

  44. Scheen A: Prevention of type 2 diabetes mellitus through inhibition of the renin-angiotensin system. Drugs 2004, 64:2537–2565.

    Article  PubMed  CAS  Google Scholar 

  45. Heymsfield SB, Segal KR, Hauptman J, et al.: Effects of weight loss with orlistat on glucose tolerance and progression to type 2 diabetes in obese adults. Arch Intern Med 2000, 160:1321–1326.

    Article  PubMed  CAS  Google Scholar 

  46. Torgerson JS, Hauptman J, Boldrin MN, et al.: Xenical in the prevention of diabetes in obese subjects (XENDOS) Study. Diabetes Care 2004, 27:155–161.

    Article  PubMed  CAS  Google Scholar 

  47. Despres JP, Golay A, Sjostrom L, et al.: Effects of rimonabant on metabolic risk factors in overweight patients with dyslipidemia. N Engl J Med 2005, 353:2121–2134.

    Article  PubMed  CAS  Google Scholar 

  48. Van Gaal LF, Rissanen AM, Scheen AJ, et al.: Effects of the cannabinoid-1 receptor blocker rimonabant on weight reduction and cardiovascular risk factors in overweight patients: 1-year experience from the RIO-Europe study. Lancet 2005, 365:1389–1397.

    Article  PubMed  Google Scholar 

  49. Pi-Sunyer FX, Aronne LJ, Heshmati HM, et al.: Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients. JAMA 2006, 295:761–775.

    Article  PubMed  CAS  Google Scholar 

  50. Scheen AJ, Finer N, Hollander P, et al.: Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes. Lancet 2006, 368:1160–1172.

    Google Scholar 

  51. McFarlane SI, Muniyappa R, Francisco R, et al.: Clinical review 145: Pleiotropic effects of statins: lipid reduction and beyond. J Clin Endocrinol Metab 2002, 87:1451–1458.

    Article  PubMed  CAS  Google Scholar 

  52. Freeman DJ, Norrie J, Sattar N, et al.: Pravastatin and the Development of diabetes mellitus: evidence of a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation 2001, 103:357–362.

    PubMed  CAS  Google Scholar 

  53. Tenenbaum A, Motro M, Fisman EZ: Dual and panperoxisome proliferator receptor (PPAR) co-agonism: the bezafibrate lessons. Cardiovasc Diabetol 2005, 4:14.

    Article  PubMed  Google Scholar 

  54. Rovellini A, Sommariva D, Branchi A, et al.: Effects of slow release bezafibrate on the lipid pattern and on blood glucose of type 2 diabetic patients with hyperlipidaemia. Pharmacol Res 1992, 25:237–245.

    Article  PubMed  CAS  Google Scholar 

  55. Tenenbaum A, Motro M, Fisman EZ, et al.: Effect of bezafibrate on incidence of type 2 diabetes mellitus in obese patients. Eur Heart J 2005, 26:2032–2038.

    Article  PubMed  CAS  Google Scholar 

  56. Tenenbaum A, Motro M, Fisman E, et al.: Peroxisome proliferator-activated receptor ligand bezafibrate for prevention of type 2 diabetes mellitus in patients with coronary artery disease. Circulation 2004, 109:2197–2202.

    Article  PubMed  CAS  Google Scholar 

  57. Sjostrom L, Lindroos AK, Peltonen M, et al.: Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Eng J Med 2004, 351:2683–2693.

    Article  Google Scholar 

  58. Sjostrom CD: Surgery as an intervention for obesity. Results from the Swedish Obese Subjects Study. Growth Horm IGF Res 2003, 13:S22–S26.

    Article  PubMed  Google Scholar 

  59. Pories WJ, Swanson MS, MacDonald KG, et al.: Who would have thought it? An operation proves to be the most effective therapy for adult onset diabetes mellitus. Ann Surg 1995, 222:339–350.

    Article  PubMed  CAS  Google Scholar 

  60. Long SD, O’Brien K, MacDonald KG Jr, et al.: Weight loss in severely obese subjects prevents the prevention of impaired glucose tolerance test to type II diabetes. A longitudinal interventional study. Diabetes Care 1994, 17:372–375.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amal Farag MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Farag, A., Karam, J., Nicasio, J. et al. Prevention of type 2 diabetes: An update. Curr Diab Rep 7, 200–207 (2007). https://doi.org/10.1007/s11892-007-0032-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-007-0032-4

Keywords

Navigation