Boyne, Michael S
Author Affiliation, Ana.
Tropical Metabolism Research Unit
Prevention of type 2 diabetes mellitus in high-risk patients
Preventive Medicine in Managed Care
Date of Publication
The increasing prevalence of type 2 diabetes mellitus constitutes a significant public health burden, placing a greater importance on the primary prevention of type 2 diabetes. High-risk individuals (those with impaired glucose tolerance, impaired fasting glucose, the insulin resistance syndrome, gestational diabetes, and a family history of diabetes) should be identified for intervention. The evidence for the efficacy of lifestyle intervention, including weight management, physical activity, dietary composition, and tobacco abuse is reviewed. The potential roles of pharmacologic agents (ie, metformin, thiazolidinediones, acarbose, orlistat, and angiotensin-converting enzyme inhibitors) are also discussed. It is hoped that the Diabetes Prevention Program trial, when completed, will provide guidelines for incorporating lifestyle intervention and pharmacotherapy into an effective interventional program for the high-risk individual.....