Primary Care Diabetes
Volume 1, Issue 1 , Pages 5-11, February 2007

Is prevention of Type-2 diabetes feasible and efficient in primary care?

A systematic PubMed review

  • Torsten Lauritzen

      Affiliations

    • Institute of Public Health, Department of General Practice, University of Aarhus, Denmark
    • Corresponding Author InformationCorresponding author at: Institute of Public Health, Department of General Practice, University of Aarhus, Vennelyst Boulevard 6, DK 8000 Århus, Denmark. Tel.: +45 89426047.
    • ,
  • Knut Borch-Johnsen

      Affiliations

    • Steno Diabetes Centre, Gentofte, Denmark
    • University of Aarhus, Denmark
    • ,
  • Annelli Sandbæk

      Affiliations

    • Institute of Public Health, Department of General Practice, University of Aarhus, Denmark

Received 24 April 2006; received in revised form 7 November 2006; accepted 24 November 2006. published online 02 January 2007.

Abstract 

Aim

To answer: (1) Do we have effective treatments to improve prognosis for those identified at risk of Type-2 diabetes? (2) Will prevention be cost-effective?

Methods

A systematic search was done in PubMed using the following search strategy: “diabetes AND prevention AND (IFG OR IGT)”. Restrictions were: “English, Meta-Analysis, Randomized Controlled Trial, Review, Humans”.

Results

Few randomised controlled preventive trials were found. Almost all were done in research settings in people with high risk of developing Type-2 diabetes. It seems possible to either delay or prevent Type-2 diabetes through lifestyle interventions and medication. Cost–utility analyses are few in number and come to very different conclusions as to whether health policy should promote prevention of Type-2 diabetes.

Conclusion

Intervention studies using lifestyle counselling and drug therapy in research settings illustrate promising results with lowering of the incidence of Type-2 diabetes, meaning that Type-2 diabetes can be delayed or prevented. It is, however, questionable whether these interventions are cost-effective. We need studies in routine clinical settings evaluating morbidity, mortality and cost-effectiveness as primary outcomes. While waiting for these studies to prove cost-effective, patients with pre-diabetes should be treated according to their 10-year risk of cardiovascular disease following present guidelines.

Keywords: Type-2 diabetes, IGT, IFG, Screening, Lifestyle intervention, Pharmacological intervention, Cost-effectiveness

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S1751-9918(06)00009-X

doi:10.1016/j.pcd.2006.11.001

Primary Care Diabetes
Volume 1, Issue 1 , Pages 5-11, February 2007

Article Tools