Diabetes mellitus type 2 primary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
There two recommended methods for reducing the risk of [[Diabetes mellitus type 2|type 2 diabetes]] development. Life style modification is the | There two recommended methods for reducing the risk of [[Diabetes mellitus type 2|type 2 diabetes]] development. Life style modification is the mainstay for [[diabetes mellitus]] [[Prevention (medical)|prevention]], which includes [[Diet (nutrition)|diet]] considerations as well as regular [[Physical exercise]]. [[Metformin]] is another adjunctive measure to prevent [[diabetes]] in high risk persons. | ||
==Primary Prevention== | ==Primary Prevention== | ||
*[[Prevention (medical)|prevention]] of [[diabetes mellitus type 2]] is based on two major concepts: Life style modification and [[Pharmacology|pharmacological]] [[Prevention (medical)|prevention]]. Life style modification is more effective than [[Pharmacology|pharmacological]] intervention. <ref>J. Sonya | *[[Prevention (medical)|prevention]] of [[diabetes mellitus type 2]] is based on two major concepts: Life style modification and [[Pharmacology|pharmacological]] [[Prevention (medical)|prevention]]. Life style modification is more effective than [[Pharmacology|pharmacological]] intervention. Effects of life style modification usually last longer than [[Pharmacology|pharmacological]] intervention. <ref name="HawGalaviz2017">{{cite journal|last1=Haw|first1=J. Sonya|last2=Galaviz|first2=Karla I.|last3=Straus|first3=Audrey N.|last4=Kowalski|first4=Alysse J.|last5=Magee|first5=Matthew J.|last6=Weber|first6=Mary Beth|last7=Wei|first7=Jingkai|last8=Narayan|first8=K. M. Venkat|last9=Ali|first9=Mohammed K.|title=Long-term Sustainability of Diabetes Prevention Approaches|journal=JAMA Internal Medicine|volume=177|issue=12|year=2017|pages=1808|issn=2168-6106|doi=10.1001/jamainternmed.2017.6040}}</ref> | ||
===Life style modification=== | ===Life style modification=== | ||
*Studies have shown that 7% [[weight loss]] during 6 months in [[Obesity|obese]] individuals is effective for [[diabetes]] [[Prevention (medical)|prevention]].<ref name="pmid17098085">{{cite journal |vauthors=Lindström J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemiö K, Hämäläinen H, Härkönen P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J |title=Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study |journal=Lancet |volume=368 |issue=9548 |pages=1673–9 |year=2006 |pmid=17098085 |doi=10.1016/S0140-6736(06)69701-8 |url=}}</ref> | *Studies have shown that 7% [[weight loss]] during 6 months in [[Obesity|obese]] individuals is effective for [[diabetes]] [[Prevention (medical)|prevention]].<ref name="pmid17098085">{{cite journal |vauthors=Lindström J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemiö K, Hämäläinen H, Härkönen P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J |title=Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study |journal=Lancet |volume=368 |issue=9548 |pages=1673–9 |year=2006 |pmid=17098085 |doi=10.1016/S0140-6736(06)69701-8 |url=}}</ref> | ||
*The recommended pace of [[weight loss]] is 1–2 lb/week. | *The recommended pace of [[weight loss]] is 1–2 lb/week.<ref name="pmid11707561">{{cite journal| author=Anderson JW, Konz EC| title=Obesity and disease management: effects of weight loss on comorbid conditions. | journal=Obes Res | year= 2001 | volume= 9 Suppl 4 | issue= | pages= 326S-334S | pmid=11707561 | doi=10.1038/oby.2001.138 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11707561 }} </ref> | ||
*[[Calorie]] goals were calculated by estimating the daily [[Calorie|calories]] needed to maintain the participant’s initial weight and subtracting 500–1,000 calories/day. Reducing caloric intake is of paramount importance for those at high risk for developing [[Diabetes mellitus type 2|type 2 diabetes]]. | *[[Calorie]] goals were calculated by estimating the daily [[Calorie|calories]] needed to maintain the participant’s initial weight and subtracting 500–1,000 calories/day. Reducing caloric intake is of paramount importance for those at high risk for developing [[Diabetes mellitus type 2|type 2 diabetes]]. | ||
*Reducing [[fat]] intake and [[fat]] quality is also important in this group. | *Reducing [[fat]] intake and [[fat]] quality is also important in this group.<ref name="pmid11707561">{{cite journal| author=Anderson JW, Konz EC| title=Obesity and disease management: effects of weight loss on comorbid conditions. | journal=Obes Res | year= 2001 | volume= 9 Suppl 4 | issue= | pages= 326S-334S | pmid=11707561 | doi=10.1038/oby.2001.138 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11707561 }} </ref> | ||
*[[Grains of Selim|Grains]] may help to prevent [[Diabetes mellitus type 2|type 2 diabetes]].<ref name="pmid12600852">{{cite journal |vauthors=Montonen J, Knekt P, Järvinen R, Aromaa A, Reunanen A |title=Whole-grain and fiber intake and the incidence of type 2 diabetes |journal=Am. J. Clin. Nutr. |volume=77 |issue=3 |pages=622–9 |year=2003 |pmid=12600852 |doi= |url=}}</ref> | *[[Grains of Selim|Grains]] may help to prevent [[Diabetes mellitus type 2|type 2 diabetes]].<ref name="pmid12600852">{{cite journal |vauthors=Montonen J, Knekt P, Järvinen R, Aromaa A, Reunanen A |title=Whole-grain and fiber intake and the incidence of type 2 diabetes |journal=Am. J. Clin. Nutr. |volume=77 |issue=3 |pages=622–9 |year=2003 |pmid=12600852 |doi= |url=}}</ref> | ||
*Higher intakes of [[Nut (fruit)|nuts]], <ref name="pmid24898241">{{cite journal |vauthors=Afshin A, Micha R, Khatibzadeh S, Mozaffarian D |title=Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis |journal=Am. J. Clin. Nutr. |volume=100 |issue=1 |pages=278–88 |year=2014 |pmid=24898241 |pmc=4144102 |doi=10.3945/ajcn.113.076901 |url=}}</ref> berries<ref name="pmid24257723">{{cite journal |vauthors=Mursu J, Virtanen JK, Tuomainen TP, Nurmi T, Voutilainen S |title=Intake of fruit, berries, and vegetables and risk of type 2 diabetes in Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study |journal=Am. J. Clin. Nutr. |volume=99 |issue=2 |pages=328–33 |year=2014 |pmid=24257723 |doi=10.3945/ajcn.113.069641 |url=}}</ref>, yogurt<ref name="pmid25420418">{{cite journal |vauthors=Chen M, Sun Q, Giovannucci E, Mozaffarian D, Manson JE, Willett WC, Hu FB |title=Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis |journal=BMC Med |volume=12 |issue= |pages=215 |year=2014 |pmid=25420418 |pmc=4243376 |doi=10.1186/s12916-014-0215-1 |url=}}</ref>, coffee and tea<ref name="pmid26746178">{{cite journal |vauthors=Mozaffarian D |title=Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review |journal=Circulation |volume=133 |issue=2 |pages=187–225 |year=2016 |pmid=26746178 |pmc=4814348 |doi=10.1161/CIRCULATIONAHA.115.018585 |url=}}</ref> are associated with reduced [[diabetes]] risk. | *Higher intakes of [[Nut (fruit)|nuts]], <ref name="pmid24898241">{{cite journal |vauthors=Afshin A, Micha R, Khatibzadeh S, Mozaffarian D |title=Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis |journal=Am. J. Clin. Nutr. |volume=100 |issue=1 |pages=278–88 |year=2014 |pmid=24898241 |pmc=4144102 |doi=10.3945/ajcn.113.076901 |url=}}</ref> berries<ref name="pmid24257723">{{cite journal |vauthors=Mursu J, Virtanen JK, Tuomainen TP, Nurmi T, Voutilainen S |title=Intake of fruit, berries, and vegetables and risk of type 2 diabetes in Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study |journal=Am. J. Clin. Nutr. |volume=99 |issue=2 |pages=328–33 |year=2014 |pmid=24257723 |doi=10.3945/ajcn.113.069641 |url=}}</ref>, yogurt<ref name="pmid25420418">{{cite journal |vauthors=Chen M, Sun Q, Giovannucci E, Mozaffarian D, Manson JE, Willett WC, Hu FB |title=Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis |journal=BMC Med |volume=12 |issue= |pages=215 |year=2014 |pmid=25420418 |pmc=4243376 |doi=10.1186/s12916-014-0215-1 |url=}}</ref>, coffee and tea<ref name="pmid26746178">{{cite journal |vauthors=Mozaffarian D |title=Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review |journal=Circulation |volume=133 |issue=2 |pages=187–225 |year=2016 |pmid=26746178 |pmc=4814348 |doi=10.1161/CIRCULATIONAHA.115.018585 |url=}}</ref> are associated with reduced [[diabetes]] risk. | ||
Latest revision as of 20:05, 23 October 2020
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Diabetes mellitus type 2 Microchapters |
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Differentiating Diabetes Mellitus Type 2 from other Diseases |
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Diagnosis |
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Treatment |
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Medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
There two recommended methods for reducing the risk of type 2 diabetes development. Life style modification is the mainstay for diabetes mellitus prevention, which includes diet considerations as well as regular Physical exercise. Metformin is another adjunctive measure to prevent diabetes in high risk persons.
Primary Prevention
- prevention of diabetes mellitus type 2 is based on two major concepts: Life style modification and pharmacological prevention. Life style modification is more effective than pharmacological intervention. Effects of life style modification usually last longer than pharmacological intervention. [1]
Life style modification
- Studies have shown that 7% weight loss during 6 months in obese individuals is effective for diabetes prevention.[2]
- The recommended pace of weight loss is 1–2 lb/week.[3]
- Calorie goals were calculated by estimating the daily calories needed to maintain the participant’s initial weight and subtracting 500–1,000 calories/day. Reducing caloric intake is of paramount importance for those at high risk for developing type 2 diabetes.
- Reducing fat intake and fat quality is also important in this group.[3]
- Grains may help to prevent type 2 diabetes.[4]
- Higher intakes of nuts, [5] berries[6], yogurt[7], coffee and tea[8] are associated with reduced diabetes risk.
- Conversely, red meats and sugar sweetened beverages are associated with an increased risk of type 2 diabetes.[9]
- 150 min/week of moderate intensity physical activity, such as brisk walking, showed beneficial effects in those with prediabetes.[10]
- Moderate intensity physical activity has been shown to improve insulin sensitivity and reduce abdominal fat in children and young adults.[11][12]
Pharmacologic intervention
- Metformin therapy for prevention of type 2 diabetes should be considered in those with prediabetes, especially for those with BMI >35 kg/m2, age > 60 years, women with prior gestational diabetes mellitus, and/or those with rising A1C despite lifestyle intervention.
References
- ↑ Haw, J. Sonya; Galaviz, Karla I.; Straus, Audrey N.; Kowalski, Alysse J.; Magee, Matthew J.; Weber, Mary Beth; Wei, Jingkai; Narayan, K. M. Venkat; Ali, Mohammed K. (2017). "Long-term Sustainability of Diabetes Prevention Approaches". JAMA Internal Medicine. 177 (12): 1808. doi:10.1001/jamainternmed.2017.6040. ISSN 2168-6106.
- ↑ Lindström J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemiö K, Hämäläinen H, Härkönen P, Keinänen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J (2006). "Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study". Lancet. 368 (9548): 1673–9. doi:10.1016/S0140-6736(06)69701-8. PMID 17098085.
- ↑ 3.0 3.1 Anderson JW, Konz EC (2001). "Obesity and disease management: effects of weight loss on comorbid conditions". Obes Res. 9 Suppl 4: 326S–334S. doi:10.1038/oby.2001.138. PMID 11707561.
- ↑ Montonen J, Knekt P, Järvinen R, Aromaa A, Reunanen A (2003). "Whole-grain and fiber intake and the incidence of type 2 diabetes". Am. J. Clin. Nutr. 77 (3): 622–9. PMID 12600852.
- ↑ Afshin A, Micha R, Khatibzadeh S, Mozaffarian D (2014). "Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis". Am. J. Clin. Nutr. 100 (1): 278–88. doi:10.3945/ajcn.113.076901. PMC 4144102. PMID 24898241.
- ↑ Mursu J, Virtanen JK, Tuomainen TP, Nurmi T, Voutilainen S (2014). "Intake of fruit, berries, and vegetables and risk of type 2 diabetes in Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study". Am. J. Clin. Nutr. 99 (2): 328–33. doi:10.3945/ajcn.113.069641. PMID 24257723.
- ↑ Chen M, Sun Q, Giovannucci E, Mozaffarian D, Manson JE, Willett WC, Hu FB (2014). "Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis". BMC Med. 12: 215. doi:10.1186/s12916-014-0215-1. PMC 4243376. PMID 25420418.
- ↑ Mozaffarian D (2016). "Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review". Circulation. 133 (2): 187–225. doi:10.1161/CIRCULATIONAHA.115.018585. PMC 4814348. PMID 26746178.
- ↑ Ley SH, Hamdy O, Mohan V, Hu FB (2014). "Prevention and management of type 2 diabetes: dietary components and nutritional strategies". Lancet. 383 (9933): 1999–2007. doi:10.1016/S0140-6736(14)60613-9. PMC 4751088. PMID 24910231.
- ↑ O'Brien MJ, Perez A, Scanlan AB, Alos VA, Whitaker RC, Foster GD, Ackermann RT, Ciolino JD, Homko C (2017). "PREVENT-DM Comparative Effectiveness Trial of Lifestyle Intervention and Metformin". Am J Prev Med. doi:10.1016/j.amepre.2017.01.008. PMID 28237635.
- ↑ Fedewa MV, Gist NH, Evans EM, Dishman RK (2014). "Exercise and insulin resistance in youth: a meta-analysis". Pediatrics. 133 (1): e163–74. doi:10.1542/peds.2013-2718. PMID 24298011.
- ↑ Davis CL, Pollock NK, Waller JL, Allison JD, Dennis BA, Bassali R, Meléndez A, Boyle CA, Gower BA (2012). "Exercise dose and diabetes risk in overweight and obese children: a randomized controlled trial". JAMA. 308 (11): 1103–12. doi:10.1001/2012.jama.10762. PMC 3487697. PMID 22990269.