[Strategy and practice in the prevention of type-2 diabetes]

In Taiwan, Type 2 diabetes is a common chronic disease and a major cause of mortality because of the adverse complications with which it afflicts the cardiovascular, renal and neurological systems. The Bureau of National Health Insurance has begun to address issues of diabetes prevention. Statistics indicate that patients with diabetes account for 11.5% of all medical expenditure by this Bureau. Evidence from the literature suggests that a policy of prevention ought to be more effective than the early detection and treatment of diabetes. This paper recommends a case management system that is sensitive to Taiwan culture and involves the promotion of a healthy lifestyle, "the LOHAS executants", to promote efficient strategies and interventions for the prevention of diabetes. The focus of the approach is one of a gradual change in an individual's lifestyle, including physical activity, a healthy diet and behavior modification. Adherence to the interventions is determined through consultation and monitoring by a case manager. All procedures are tailored and kept convenient, in order to help the participants to achieve or maintain their goals. Overall, in the future, the prevention of type 2 diabetes in high-risk individuals will reduce the tremendous burden on national medical resources created by this disease, and help those people to develop an optimal quality of life.