A European Evidence-Based Guideline for the Prevention of Type 2 Diabetes

被引：335

作者：

Paulweber, B. ^{[4
]}

Valensi, P. ^{[5
]}

Lindstrom, J. ^{[6
]}

Lalic, N. M. ^{[7
]}

Greaves, C. J. ^{[8
]}

McKee, M. ^{[9
]}

Kissimova-Skarbek, K. ^{[10
]}

Liatis, S. ^{[11
]}

Cosson, E. ^{[5
]}

Szendroedi, J. ^{[2
,3
]}

Sheppard, K. E. ^{[8
]}

Charlesworth, K. ^{[9
]}

Felton, A. -M. ^{[12
]}

Hall, M.

Rissanen, A. ^{[13
,14
]}

Tuomilehto, J. ^{[15
,16
,17
]}

Schwarz, P. E. ^{[18
]}

Roden, M. ^{[1
,2
,3
]}

机构：

[1] Hanusch Hosp, Karl Landsteiner Inst Endocrinol & Metab, A-1140 Vienna, Austria

[2] Univ Dusseldorf, Inst Clin Diabetol, German Diabet Ctr, Dusseldorf, Germany

[3] Univ Dusseldorf, Dept Metab Dis, Dusseldorf, Germany

[4] Paracelsus Med Univ, Salzburg, Austria

[5] Univ Paris 13, CRNH IdF, AP HP, Dept Endocrinol Diabetol Nutr,Jean Verdier Hosp, Bondy, France

[6] Natl Inst Hlth & Welf THL, Diabet Prevent Unit, Dept Chron Dis Prevent, Helsinki, Finland

[7] Univ Belgrade, Inst Endocrinol, Diabet & Metab Dis Sch Med, Diabet Ctr,Clin Ctr Serbia, Belgrade, Serbia

[8] Univ Exeter, Peninsula Med Sch, Exeter, Devon, England

[9] London Sch Hyg & Trop Med, European Ctr Hlth Soc Transit, London WC1, England

[10] IDF, Execut Off, Brussels, Belgium

[11] Univ Athens, Sch Med, Laiko Hosp, Ctr Diabet, GR-11527 Athens, Greece

[12] FEND, London, England

[13] EASO, Helsinki, Finland

[14] Univ Helsinki, Cent Hosp, Obes Res Unit, Helsinki, Finland

[15] S Ostrobothnia Cent Hosp, Seinajoki, Finland

[16] Univ Helsinki, Dept Publ Hlth, Hjelt Inst, Helsinki, Finland

[17] Spanish Diabet Fdn, Madrid, Spain

[18] Tech Univ Dresden, Carl Gustav Carus Med Fac, Dresden, Germany

来源：

HORMONE AND METABOLIC RESEARCH | 2010年 / 42卷

基金：

美国国家卫生研究院;

关键词：

IMPAIRED GLUCOSE-TOLERANCE; LIFE-STYLE INTERVENTION; GENOME-WIDE ASSOCIATION; PERSISTENT ORGANIC POLLUTANTS; CARDIOVASCULAR RISK-FACTORS; WORLD-HEALTH-ORGANIZATION; POLYCYSTIC-OVARY-SYNDROME; RENIN-ANGIOTENSIN SYSTEM; CORONARY-HEART-DISEASE; FATTY-ACID-COMPOSITION;

D O I：

10.1055/s-0029-1240928

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide. Aims: This guideline provides evidence-based recommendations for preventing T2DM. Methods: A European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria. Results: Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number-needed-to-treat: 6.4 over 1.8-4.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by >= 5% lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective. Conclusions: Prevention using lifestyle modifications in high-risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication.

引用

页码：S3 / S36

页数：34

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