TYPE 2 DIABETES

Dietary intervention to prevent type 2 diabetes





Dietary intervention to prevent type 2 diabetes

Introduction

Effective strategies for diabetes prevention in Bangladesh must target high risk groups, including South Asians.In the United States and Finland, intensive diet and exercise programmes have achieved a 58% reduction in incidence of diabetes in high risk groups,but such programmes may not be directly transferable to minority ethnic communities in the Bangladesh.Lay understanding of how diabetes might be prevented has important implications for the design, delivery, and uptake of diabetes prevention programmes. Previous qualitative studies of lay understandings of diabetes in Bangladeshis have been limited to participants with established diabetes. We explored the attitudes of Bangladeshis without diabetes to the risk of developing diabetes and the opportunities for preventing it. We consulted religious leaders and scholars, health professionals, and community workers about diabetes prevention in the Bangladeshi community.(Dawson,2002,1303)

Type 2 Diabetes Prevention: A Review by Kim Dalziel and Leonie Segal

This review offers a discussion of various strategies for the prevention of type 2 diabetes. It includes results from recent clinical trials targeting patients who are at highest risk for the development of diabetes, with a particular emphasis on lifestyle modification strategies and the implementation of such programs in community-based settings.

Type 2 diabetes has increased dramatically in the past two decades, with 1.6 million cases diagnosed each year in the United States.Diabetes prevalence is highest among the elderly and in certain ethnic groups, especially African Americans, Hispanic Americans, and Native Americans. People with diabetes have a two- to fourfold increased risk of developing cardiovascular disease, peripheral vascular disease, and stroke. These complications account for 65% of mortality from diabetes and, as of 2006, have made diabetes the seventh leading cause of death in the United States.(Nutbeam,2004,259)

Unfortunately, diabetes is often diagnosed relatively late in the course of the disease, at a point when many patients have already developed complications. In addition, management efforts are labor intensive and challenging for both patients and physicians. Furthermore, the economic burden associated with diabetes is substantial, with U.S. costs estimated at $174 billion in 2007 and one of every five health care dollars spent on caring for someone diagnosed with diabetes.The impact of diabetes on individuals' health and its economic burden to society have made its prevention a major goal of the current era.

In the past decade, major advances have been made in our understanding of the prevention of type 2 diabetes. Interventions that can reverse impaired glucose regulation early in its course may be the key to primary prevention of the long-term complications of diabetes.

Type 2 diabetes is a heterogeneous disorder characterized by two interrelated metabolic defects: insulin resistance coupled with impaired insulin secretion by ß-cells in the pancreas. Therefore, strategies that target these two mechanisms by improving insulin sensitivity and protecting ß-cell function have become the focus of prevention efforts. Weight loss and physical activity, as well as some medications, are thought to improve both insulin sensitivity and secretion. The results of major clinical diabetes prevention trials ...