Lifestyle and the Prevention of Type 2 Diabetes: A Status Report

Abstract

Diabetes is a costly disease affecting 387 million individuals globally and 28 million in the United States. Its precursor, prediabetes, affects 316 and 86 million individuals globally and in the United States, respectively. People living with elevated blood glucose levels are at high risk for all-cause mortality and numerous cardiometabolic ailments. Fortunately, diabetes can be prevented or delayed by maintaining a healthy lifestyle and a healthy body weight. In this review, we summarize the literature around lifestyle diabetes prevention programs and provide recommendations for introducing prevention strategies in clinical practice. Overall, evidence supports the efficacy and effectiveness of lifestyle diabetes prevention interventions across clinical and community settings, delivery formats (eg, individual-, group-, or technology-based), and implementers (eg, clinicians, community members). Evidence-based diabetes prevention strategies that can be implemented in clinical practice include brief behavior change counseling, group-based education, community referrals, and health information technologies. These strategies represent opportunities where practitioners, communities, and health care systems can work together to provide individuals with education, support and opportunities to maintain healthy, diabetes-free lifestyles.

Keywords: clinical practice; diet; impaired glucose tolerance; physical activity; prediabetes.

Figure 1.

Prediabetes and Diabetes FBG, OGTT, and HbA1c Cutoff Points According to ADA 2015. Abbreviations: ADA, American Diabetes Association; FBG, fasting blood glucose; OGTT, oral glucose tolerance test; HbA1c, hemoglobin A1c.

Figure 2.

Diabetes development process (adapted from Stumvoll et al). Abbreviation: IGT, impaired glucose tolerance.