Abstract
Diabetes, particularly type 2 diabetes mellitus (T2DM), has reached epidemic proportions
in the U.S. and globally, highlighting the need for major improvements in treatment
strategies for detecting, preventing, and slowing disease progression. Despite escalating
treatment costs, diabetes care remains largely substandard, with hospitalizations
for late-stage complications in particular placing a major burden on the healthcare
system. Although considerable advances have been made in identifying the risk factors
of diabetes and developing treatments, goals targeting prevention have remained elusive.
Although there is currently no consensus regarding terminology among public health
practitioners, the concept of prevention in terms of diabetes care runs the gamut
from interventions used to avoid disease in individuals without risk factors (primordial
prevention) to prevention of the consequences of established complications (quaternary
prevention).
Given the worldwide prevalence of diabetes, it is crucial to improve the quality of
care for those diagnosed with overt diabetes, as well as those who have been identified
as at risk for developing the disease. Earlier screening enables undiagnosed, asymptomatic
individuals with diabetes to be identified sooner, managed more effectively, and where
necessary, treated with the appropriate pharmacotherapeutic options in a timely manner.
All stakeholders (including government, industry, professional, and patient groups)
must partner in concert to address these vital issues so that treatment goals ultimately
may be realized.
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References
- National diabetes fact sheet.
- Lifetime risk for diabetes mellitus in the U.S..JAMA. 2003; 290: 1884-1890
- Obesity and type 2 diabetes: what can be unified and what needs to be individualized?.Diabetes Care. 2011; 34: 1424-1430
- Prevalence of overweight and obesity among adults with diagnosed diabetes—U.S., 1988-1994 and 1999-2002.
- Prevention of type 1 diabetes.Pediatr Clin North Am. 2011; 58: 1257-1270
- Standards of medical care in diabetes–2013.Diabetes Care. 2013; 36: S11-S66
- Prevention and control of coronary heart disease and stroke—nomenclature for prevention approaches in public health.Am J Prev Med. 2005; 2: 152-157
- Working together to manage diabetes: a guide for pharmacy, podiatry, optometry, and dental professionals.
- Projecting the future diabetes population size and related costs for the U.S..Diabetes Care. 2009; 32: 2225-2229
- Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.N Engl J Med. 2002; 346: 393-403
- Long-term effects of a community-based lifestyle intervention to prevent type 2 diabetes: the DEPLOY extension pilot study.Chronic Illn. 2011; 7: 279-290
- Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study.Lancet. 2012; 379: 2243-2251
- The Diabetes Control and Complications Trial: the gift that keeps giving.Nat Rev Endocrinol. 2009; 5: 537-545
- 10-year follow-up of intensive glucose control in type 2 diabetes.N Engl J Med. 2008; 359: 1577-1589
- Management of hyperglycaemia in type 2 diabetes: a patient-centered approach.Diabetes Care. 2012; 35: 1364-1379
- American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan.Endocr Pract. 2011; 17: 1-53
- Rule of halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care.Br J Gen Pract. 1992; 42: 116-119
- Analysis & commentary: global prevention and control of type 2 diabetes will require paradigm shifts in policies within and among countries.Health Aff. 2012; 31: 84-92
- Screening for type 2 diabetes mellitus in adults: U.S Preventive Services Task Force recommendation statement.Ann Intern Med. 2008; 148: 846-854
- Effectiveness of primary care-relevant treatments for obesity in adults [Letter to the editor].Ann Intern Med. 2012; 156: 248-249
- Analysis of guidelines for screening diabetes mellitus in an ambulatory population.Mayo Clin Proc. 2010; 85: 27-35
- Age at initiation and frequency of screening to detect type 2 diabetes: a cost-effectiveness analysis.Lancet. 2010; 375: 1365-1374
- Analysis & commentary: the U.S. Preventive Services Task Force should consider a broader evidence base in updating its diabetes screening guidelines.Health Aff. 2012; 31: 35-42
- National Diabetes Prevention Program.
- Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement.Diabetes Care. 2012; 35: 2533-2539
- Greater adherence to diabetes drugs is linked to less hospital use and could save nearly $5 billion annually.Health Aff. 2012; 31: 1836-1846
- Milestones in Novo Nordisk's history.
- Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes.N Engl J Med. 2003; 348: 383-393
- Global R&D facts and figures.
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© 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
