role of lifestyle interventions in preventing diabetes in high risk
Flavia C. Diugan, Ionut S. Vasile
of Medicine, University of Medicine and Pharmacy Craiova, Romania
mellitus (DM) represents a group of metabolic disorders characterized
by hyperglycemia that produces long-term dysfunctions, at many levels,
especially in the eyes, kidneys, cord, blood vessels and nervous
system. Through its microvascular (retinopathy, nephropathy,
neuropathy) and macrovascular complications (myocardial infarction,
stroke, peripheral arterial disease), diabetes is a major cause of
increased morbidity and reduced quality of life and life expectancy.
in 2000 the prevalence of diabetes worldwide was 2.8% (171 million
people) it is projected that in 2030 the prevalence of diabetes will be
4.4% (366 million people). It thus justifies the growing interest for
early diagnosis and active screening of patients with DM, which is the
first step to implementing early intervention, primary prevention of
this disease being a goal of major interest.
In recent years
it increasingly emerged the idea of excess metabolic and cardiovascular
risk in patients currently considered normo-glycemic but with a high
value of 1 hour post load blood glucose in the oral glucose tolerance
test OGTT. Several studies have investigated the hypothesis that
subjects with normal glucose tolerance and 1hour blood glucose in OGTT
as high as patients with impaired glucose tolerance (IGT) is an
intermediate category of patients presenting an altered metabolism
translated by increased insulin resistance and reduced β cell
susceptibility to glucose.
Cardiovascular risk and the
subsequent risk of the development of DM in this group of patients was
found to be equal to that of patients diagnosed with IGT by current
standards. These subjects at increased risk for future type 2 diabetes
are the ones that effective prevention programs target.
are overwhelming data that prove the fact that lifestyle modifications,
both diet and multiple physical activity are highly successful in
preventing diabetes and cardiovascular morbidity in high-risk
populations. Clinical guidelines are needed for the optimal community
implementation of evidence-based diabetes prevention programs.
oral glucose tolerance test, one hour glucose, early prevention Full
The role of lifestyle
interventions in preventing diabetes in high risk populations