Prevention of diabetes mellitus type 2

Main article: diabetes mellitus

Prevention of diabetes mellitus type 2 can be achieved with both lifestyle changes and medication use; onset of type 2 diabetes can often be delayed through proper nutrition and regular exercise.[1] The National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] has spent over $1 billon dollars on diabetes prevention efforts each year. Because diabetes is becoming a major problem in public health, the NIDDK conducted a study by sending YMCA fitness trainers out into the community to try and intervene into peoples' lifestyles to make them more healthy.[2]

A 2005 report concluded that "there is evidence that combined diet and exercise, as well as drug therapy (metformin, acarbose), may be effective at preventing progression to diabetes in IGT (Impaired Glucose Tolerance) subjects".[3][4]

Lifestyle

Increasing physical activity may be helpful in preventing type 2 diabetes, particularly if undertaken soon after a carbohydrate rich meal that increases blood sugar levels.[5][6][7] The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake (around 30% of energy supply should come from fat), and eating sufficient fiber (e.g., from whole grains).

Foods with low glycemic index rich in fiber and other important nutrients are recommended notwithstanding limited evidence.[8][9]

Study group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes".[10]

Various sources suggest an influence of dietary fat types. Positive effects of unsaturated fats have been asserted on theoretical grounds and observed in animal feeding studies. Hydrogenated fats are universally considered harmful mainly because of well known effect on cardiovascular risk factors.[11]

High levels of dietary trans-palmitoleic acid (a fatty acid naturally occurring in milk and other dairy products) were found in a cohort study to be correlated with reduced risk of type 2 diabetes and reduced cardiovascular risk markers.[12] Overall milk consumption may have a beneficial effect.[13]

There are numerous studies which suggest connections between some aspects of type 2 diabetes with ingestion of certain foods or with some drugs. Breastfeeding may also be associated with the prevention of type 2 diabetes in mothers.[14]

There is evidence relating consumption of coffee with prevention of type 2 diabetes. However, it is unclear if coffee causes any change in the risk of diabetes. This is true regardless of if it is caffeinated/decaffeinated; with/without sugar, or potboiled or not.[15]

Medications

Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin,[6] rosiglitazone,[16] or valsartan.[17]

Lifestyle interventions are, however, more effective than metformin at preventing diabetes regardless of weight loss.[18]

Many other medications are well known to modify risk of diabetes 2 although in most cases they are prescribed for reasons unrelated to diabetes 2. In patients on hydroxychloroquine for rheumatoid arthritis, incidence of diabetes was reduced by 77% though causal mechanisms are unclear.[19] Dopamine receptor agonists are also known to improve glycemic control, reduce insulin resistance and help controlling body weight.

References

  1. ↑ Raina Elley C, Kenealy T (December 2008). "Lifestyle interventions reduced the long-term risk of diabetes in adults with impaired glucose tolerance". Evid Based Med 13 (6): 173. doi:10.1136/ebm.13.6.173. PMID 19043031.
  2. ↑ Fradkin, Judith E., and Griffin P. Rodgers. "Diabetes research: a perspective from the National Institute of Diabetes and Digestive and Kidney Diseases." Diabetes, Feb. 2013. Web. 22 Apr. 2014.
  3. ↑ Santaguida PL, Balion C, Hunt D, et al. (August 2005). "Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose" (PDF). Evid Rep Technol Assess (Summ) (128): 1–11. PMID 16194123. Retrieved 19 July 2008.
  4. ↑ evidence report
  5. ↑ Lindström J, Ilanne-Parikka P, Peltonen M, et al. (November 2006). "Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study". The Lancet 368 (9548): 1673–9. doi:10.1016/S0140-6736(06)69701-8. PMID 17098085.
  6. 1 2 Knowler WC, Barrett-Connor E, Fowler SE, et al. (February 2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin". The New England Journal of Medicine 346 (6): 393–403. doi:10.1056/NEJMoa012512. PMC 1370926. PMID 11832527.
  7. ↑ Diabetes Prevention Program Research Group; Knowler, W. C.; Fowler, S. E.; Hamman, R. F.; Christophi, C. A.; Hoffman, H. J.; Brenneman, A. T.; Brown-Friday, J. O.; Goldberg, R.; Venditti, E.; Nathan, D. M. (2009). "10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study". Lancet 374 (9702): 1677–1686. doi:10.1016/S0140-6736(09)61457-4. PMC 3135022. PMID 19878986.
  8. ↑ American Diabetes, A.; Bantle, J.; Wylie-Rosett, J.; Albright, A.; Apovian, C.; Clark, N.; Franz, M.; Hoogwerf, B.; Lichtenstein, A.; Mayer-Davis, E.; Mooradian, A. D.; Wheeler, M. L. (2008). "Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes Association". Diabetes Care 31: S61–S78. doi:10.2337/dc08-S061. PMID 18165339.
  9. ↑ Bantle JP, Wylie-Rosett J, Albright AL, et al. (September 2006). "Nutrition recommendations and interventions for diabetes—2006: a position statement of the American Diabetes Association". Diabetes Care 29 (9): 2140–57. doi:10.2337/dc06-9914. PMID 16936169.
  10. ↑ Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovic, D (April 2009). "Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study". Archives of Internal Medicine 169 (8): 798–807. doi:10.1001/archinternmed.2009.21. PMC 2828342. PMID 19398692.
  11. ↑ Risérus U, Willett WC, Hu FB (January 2009). "Dietary fats and prevention of type 2 diabetes". Progress in Lipid Research 48 (1): 44–51. doi:10.1016/j.plipres.2008.10.002. PMC 2654180. PMID 19032965.
  12. ↑ Mozaffarian, D.; Cao, H.; King, I.; Lemaitre, R.; Song, X.; Siscovick, D.; Hotamisligil, G. (2010). "Trans-palmitoleic Acid, metabolic risk factors, and new-onset diabetes in u.s. Adults: a cohort study". Annals of Internal Medicine 153 (12): 790–799. doi:10.7326/0003-4819-153-12-201012210-00005. PMC 3056495. PMID 21173413.
  13. ↑ Choi HK, Willett WC, Stampfer P, Vasson MP, Maubois JL, Beaufrere B (2005). "Dairy consumption and risk of type 2 diabetes mellitus in men". Archives of Internal Medicine 165 (9): 997–1003. doi:10.1001/archinte.165.9.997. PMID 15883237.
  14. ↑ Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB (November 2005). "Duration of lactation and incidence of type 2 diabetes". JAMA 294 (20): 2601–10. doi:10.1001/jama.294.20.2601. PMID 16304074.
  15. ↑ Muley, A; Muley, P; Shah, M (May 2012). "Coffee to reduce risk of type 2 diabetes?: a systematic review.". Current diabetes reviews 8 (3): 162–8. doi:10.2174/157339912800564016. PMID 22497654.
  16. ↑ Gerstein HC, Yusuf S, Bosch J, et al. (September 2006). "Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial". Lancet 368 (9541): 1096–105. doi:10.1016/S0140-6736(06)69420-8. PMID 16997664.
  17. ↑ Kjeldsen SE, Julius S, Mancia G, et al. (July 2006). "Effects of valsartan compared to amlodipine on preventing type 2 diabetes in high-risk hypertensive patients: the VALUE trial". Journal of Hypertension 24 (7): 1405–12. doi:10.1097/01.hjh.0000234122.55895.5b. PMID 16794491.
  18. ↑ Knowler WC, Fowler SE, Hamman RF, et al. (November 2009). "10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study". Lancet 374 (9702): 1677–86. doi:10.1016/S0140-6736(09)61457-4. PMC 3135022. PMID 19878986.
  19. ↑ Wasko MC, Hubert HB, Lingala VB, et al. (July 2007). "Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis". JAMA 298 (2): 187–93. doi:10.1001/jama.298.2.187. PMID 17622600.
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