Prediabetes Descriptions and Recommendations
Current guidelines acknowledge that there is accumulating evidence that the onset of type 2 diabetes can be prevented or delayed, and recommend lifestyle modification for individuals with prediabetes. It is anticipated that future guidelines will provide greater guidance on managing prediabetes.
American Diabetes Association (ADA)
The ADA has produced information and tools on diabetes prevention and prediabetes for physicians and patients (www.diabetes.org), and describes prediabetes as “a serious medical condition that can be treated”. The ADA and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently produced a positioning statement on the prevention or delay of type 2 diabetes. This document states that “our knowledge of the early stages of hyperglycemia that portend the diagnosis of diabetes, and the recent success of major intervention trials, clearly show that individuals at high risk can be identified and diabetes delayed, if not prevented.” The document also acknowledges that The Study to Prevent Non-Insulin Dependent Diabetes Mellitus (STOP-NIDDM) demonstrated the ability of Glucobay to reduce the risk of developing diabetes.
European Association for the Study of Diabetes (EASD)
Guideline on cardiovascular disease (CVD) prevention were recently compiled by representatives from eight European societies, including the EASD. The guidelines recognise diabetes as a risk factor for CVD, and highlight that the development of type 2 diabetes can be prevented or delayed with lifestyle modification.
Guideline on cardiovascular disease (CVD) prevention were recently compiled by representatives from eight European societies, including the EASD. The guidelines recognise diabetes as a risk factor for CVD, and highlight that the development of type 2 diabetes can be prevented or delayed with lifestyle modification.
International Diabetes Federation (IDF)
The recent IDF global guidelines for type 2 diabetes acknowledge that “screening for diabetes will also identify individuals with lesser degrees of hyperglycaemia who may benefit from interventions to prevent or delay the development of diabetes, and to prevent cardiovascular disease.” This document also highlights the value of lifestyle modification in the prevention of diabetes. However, another publication by the IDF explains that “there is a growing feeling that people who are at high risk of developing diabetes and its complications (particularly CVD), and who have not responded to lifestyle advice, should be given drugs to reduce their risk.” Individuals at high risk of developing diabetes are considered to be those with impaired glucose tolerance (IGT). The IDF has produced factsheets on IGT and on the prevention of type 2 diabetes and has collected epidemiological data for both diabetes and IGT. Revised IDF guidelines are expected in mid 2007.
The recent IDF global guidelines for type 2 diabetes acknowledge that “screening for diabetes will also identify individuals with lesser degrees of hyperglycaemia who may benefit from interventions to prevent or delay the development of diabetes, and to prevent cardiovascular disease.” This document also highlights the value of lifestyle modification in the prevention of diabetes. However, another publication by the IDF explains that “there is a growing feeling that people who are at high risk of developing diabetes and its complications (particularly CVD), and who have not responded to lifestyle advice, should be given drugs to reduce their risk.” Individuals at high risk of developing diabetes are considered to be those with impaired glucose tolerance (IGT). The IDF has produced factsheets on IGT and on the prevention of type 2 diabetes and has collected epidemiological data for both diabetes and IGT. Revised IDF guidelines are expected in mid 2007.
World Health Organization (WHO)
Diabetes is included in the recent WHO report on chronic diseases that warrant urgent action, together with CVD and cancer.49 The report suggests that at least 80% of all CVD and type 2 diabetes can be avoided. A joint publication with the IDF explains “the urgent need for prevention of diabetes” and outlines the value of lifestyle modification. A WHO technical report on the prevention of diabetes and its complications is due to be published in 2006.
Diabetes is included in the recent WHO report on chronic diseases that warrant urgent action, together with CVD and cancer.49 The report suggests that at least 80% of all CVD and type 2 diabetes can be avoided. A joint publication with the IDF explains “the urgent need for prevention of diabetes” and outlines the value of lifestyle modification. A WHO technical report on the prevention of diabetes and its complications is due to be published in 2006.
Western Pacific Declaration on Diabetes (WPDD)
The WPDD – a partnership between the WHO Western Pacific Regional Office (WHO/WPRO), the IDF Western Pacific Region (IDF/WPR) and the Secretariat of the Pacific Community (SPC) – produced guidelines for type 2 diabetes treatment in Asia-Pacific. The guidelines emphasise the “potential for intervention in IGT subjects to reduce the development of type 2 diabetes”. While recommending lifestyle modification, the guidelines acknowledge that this form of intervention may not be sufficient and that “therapeutic intervention with drugs, such as metformin, a-glucosidase inhibitors, thiazolidinediones and angiotensin-converting enzyme (ACE) inhibitors, might be used for prevention as well.” STOP-NIDDM is cited as providing evidence that pharmacotherapy can prevent the development of diabetes.
The WPDD – a partnership between the WHO Western Pacific Regional Office (WHO/WPRO), the IDF Western Pacific Region (IDF/WPR) and the Secretariat of the Pacific Community (SPC) – produced guidelines for type 2 diabetes treatment in Asia-Pacific. The guidelines emphasise the “potential for intervention in IGT subjects to reduce the development of type 2 diabetes”. While recommending lifestyle modification, the guidelines acknowledge that this form of intervention may not be sufficient and that “therapeutic intervention with drugs, such as metformin, a-glucosidase inhibitors, thiazolidinediones and angiotensin-converting enzyme (ACE) inhibitors, might be used for prevention as well.” STOP-NIDDM is cited as providing evidence that pharmacotherapy can prevent the development of diabetes.
