Guiding diabetes screening and prevention: rationale, recommendations and remaining challenges

Area of Science:

• Endocrinology and Metabolic Diseases
• Public Health and Epidemiology
• Preventive Medicine

Background:

• Current diabetes management strategies are insufficient to curb rising morbidity, mortality, and costs.
• Prevention efforts are crucial for significant impact on diabetes burden.
• Type 2 diabetes prevention is achievable in high-risk groups through lifestyle interventions and pharmacotherapy.

Purpose of the Study:

• To review the evidence on the efficacy, sustainability, and safety of interventions for type 2 diabetes prevention.
• To assess the feasibility of implementing lifestyle intervention programs across various settings.
• To identify challenges in the widespread translation of diabetes prevention strategies.

Main Methods:

• Systematic review of research on lifestyle interventions and medications for type 2 diabetes prevention.
• Analysis of implementation studies evaluating program feasibility in diverse settings.
• Evaluation of data on efficacy, sustainability, and safety of metformin and other pharmacotherapies.

Main Results:

• Lifestyle interventions and metformin are well-supported by comprehensive efficacy, sustainability, and safety data.
• Other medications also show promise in diabetes pharmacoprevention.
• Implementation studies confirm the feasibility of lifestyle programs in healthcare settings, communities, and governmental levels.

Conclusions:

• Lifestyle interventions and pharmacotherapy, particularly metformin, are effective for type 2 diabetes prevention.
• Successful translation of these interventions requires addressing challenges in widespread adoption and engagement of at-risk individuals.
• Multilevel prevention efforts are imperative for substantial impact on diabetes-related health outcomes and costs.