Who Should We Target for Diabetes Prevention and Diabetes Risk Reduction?

Who Should We Target for Diabetes Prevention and Diabetes Risk Reduction? Screening for individual diabetes risk is crucial to identify adult and pediatric high-risk target populations for referral into successful diabetes prevention programs. Determination of impaired glucose tolerance or elevated fasting glucose levels has been the “gold standard” to classify subjects at increased risk for and/or to diagnose type 2 diabetes (T2DM). However, this led to ignoring many individuals prone to develop the disease. Therefore, using a stepped strategy consisting of a preliminary assessment of risk factors, by using risk scores such as the Finnish Diabetes Risk Score (FINDRISC) adapted to the respective population, followed by a single blood test determining blood glucose or hemoglobin A1c, respectively, or an oral glucose tolerance test is a feasible and pragmatic method to more accurately detect individuals at risk for T2DM. Inclusion of further risk factors into the assessment such as physical inactivity, waist circumference, and prenatal factors needs to be thoroughly discussed to establish a valid and reliable stepped approach applicable to real world health care. This article provides an overview of the current literature and is intentionally focused on the identification of high-risk populations (both adult and pediatric) that will help to address the key issues around the prevention of T2DM in health care settings. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Diabetes Reports Springer Journals

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Publisher
Springer Journals
Copyright
Copyright © 2012 by Springer Science+Business Media, LLC
Subject
Medicine & Public Health; Diabetes
ISSN
1534-4827
eISSN
1539-0829
DOI
10.1007/s11892-012-0255-x
pmid
22298028
Publisher site
See Article on Publisher Site

Abstract

Screening for individual diabetes risk is crucial to identify adult and pediatric high-risk target populations for referral into successful diabetes prevention programs. Determination of impaired glucose tolerance or elevated fasting glucose levels has been the “gold standard” to classify subjects at increased risk for and/or to diagnose type 2 diabetes (T2DM). However, this led to ignoring many individuals prone to develop the disease. Therefore, using a stepped strategy consisting of a preliminary assessment of risk factors, by using risk scores such as the Finnish Diabetes Risk Score (FINDRISC) adapted to the respective population, followed by a single blood test determining blood glucose or hemoglobin A1c, respectively, or an oral glucose tolerance test is a feasible and pragmatic method to more accurately detect individuals at risk for T2DM. Inclusion of further risk factors into the assessment such as physical inactivity, waist circumference, and prenatal factors needs to be thoroughly discussed to establish a valid and reliable stepped approach applicable to real world health care. This article provides an overview of the current literature and is intentionally focused on the identification of high-risk populations (both adult and pediatric) that will help to address the key issues around the prevention of T2DM in health care settings.

Journal

Current Diabetes ReportsSpringer Journals

Published: Feb 2, 2012

References

  • Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention
    Unwin, N
  • The Leicester Risk Assessment score for detecting undiagnosed Type 2 diabetes and impaired glucose regulation for use in a multiethnic UK setting
    Gray, LJ
  • International Diabetes Federation guideline for management of postmeal glucose: a review of recommendations
    Ceriello, A; Colagiuri, S
  • Pre-diabetes essential action: a European perspective
    Valensi, P
  • Can a screening programme for diabetes be applied to another population?
    Glumer, C; Borch-Johnsen, K; Colagiuri, S
  • Plasma glucose concentration and prediction of future risk of type 2 diabetes
    Abdul-Ghani, MA; DeFronzo, RA
  • Exercise as a therapeutic intervention for the prevention and treatment of insulin resistance
    Hawley, JA
  • Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease
    Bassuk, SS; Manson, JE
  • Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study
    Laaksonen, DE
  • International prevalence of physical activity in youth and adults
    Sisson, SB; Katzmarzyk, PT
  • High visceral fat mass and high liver fat are associated with resistance to lifestyle intervention
    Thamer, C
  • The metabolic syndrome in children and adolescents
    Zimmet, P
  • Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk
    Ehret, GB
  • Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study
    Fox, ER
  • Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis
    Hales, CN; Barker, DJ

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