The science type 2 diabetes prevention
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The Science: Type 2 Diabetes Prevention. The DPP was a major clinical trial to determine whether diet and exercise or the oral diabetes drug metformin could prevent or delay the onset of type 2 diabetes. DPP Research Group. N Engl J Med 2002, Vol.346, No. 6. Diabetes Prevention Program (DPP).

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The Science: Type 2 Diabetes Prevention

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The science type 2 diabetes prevention

The Science: Type 2 Diabetes Prevention


Diabetes prevention program dpp

The DPP was a major clinical trial to determine whether diet and exercise or the oral diabetes drug metformin could prevent or delay the onset of type 2 diabetes.

DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.

Diabetes Prevention Program (DPP)


Dpp participants

DPP Participants

Adults at high risk for type 2 diabetes

Presence of IGT

Mean age 51 years

Mean body mass index (BMI) 34

68% women

45% minority groups

African Americans

Hispanics/Latinos

American Indians

Asian Americans and Pacific Islanders

DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.


Dpp methods

DPP Methods

Lifestyle intervention

5% to 7% weight reduction

Healthy low-calorie, low-fat diet

30 minutes of physical activity, 5 days a week

Metformin

Oral diabetes drug

Placebo

DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.


Dpp methods1

DPP Methods

DPP Curriculum:

Diet

Exercise

Behavior change modification

Taught one-on-one by case managers

DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.


Diabetes prevention program outcomes study dppos

Diabetes Prevention Program Outcomes Study (DPPOS)

Follow-up study to the DPP

Assess the long-term effects of the DPP interventions on the development of type 2 diabetes and its complications


Diabetes prevention program outcomes study dppos1

Diabetes Prevention Program Outcomes Study (DPPOS)

After 10 years’ follow up, lifestyle intervention:

reduced the rate of developing type 2 diabetes by 34%

reduced the rate of developing type 2 diabetes by 49% in those age 60 and older

delayed type 2 diabetes by about 4 years

reduced cardiovascular risk factors

Reduced A1C and FPG

DPP Research Group. The Lancet 2009: Vol.374, No. 9702.


Diabetes prevention program outcomes study dppos2

Diabetes Prevention Program Outcomes Study (DPPOS)

At 10 years’ follow up, metformin

reduced the rate of developing diabetes by 18% compared with placebo.

delayed diabetes by 2 years compared with placebo.

reduced A1C and fasting glucose compared with placebo.

DPP Research Group. The Lancet 2009: Vol.374, No. 9702.


Diabetes prevention program outcomes study dppos3

Diabetes Prevention Program Outcomes Study (DPPOS)

Preliminary results

8% of participants with pre-diabetes had diabetic eye disease (retinopathy)

12.6% of participants with type 2 diabetes who developed diabetes during the DPP had diabetic eye disease

These findings suggest that patients with pre-diabetes or newly diagnosed type 2 diabetes should be screened for retinopathy.

DPP Research Group. Diabetic Medicine 2007; 24 (2); 137-144.


Diabetes prevention

Diabetes Prevention

79 million U.S. adults ages 20 and older have pre-diabetes

National Diabetes Fact Sheet, CDC, 2011.

http://www.cdc.gov/diabetes/pubs/factsheet11.htm


What is pre diabetes

What is Pre-diabetes?

Pre-diabetes is a medical condition where blood glucose is higher than normal but not high enough to be diagnosed as diabetes

It increases the risk for type 2 diabetes and cardiovascular disease

Most people have pre-diabetes before they develop type 2 diabetes

American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.


What is pre diabetes1

What is Pre-diabetes?

Most people with pre-diabetes develop type 2 diabetes within 10 years

People with pre-diabetes are identified by having a screening test which shows they have IFG, IGT or an A1C of 5.7% - 6.4%

Progression to diabetes is NOT inevitable

American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.


Risk factors for diabetes

History of vascular disease

Signs of insulin resistance

(such as PCOS or acanthosisnigricans)

Pre-diabetes

Inactive lifestyle

American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.

Risk Factors for Diabetes

  • Age 45 and older

  • Overweight (BMI ≥ 25)

  • Hypertension

  • Abnormal lipid levels

  • Family history of diabetes

  • Race/ethnicity

  • History of gestational diabetes


Testing for diabetes and pre diabetes

Testing for Diabetes and Pre-Diabetes

Consider testing if person is:

Age 45 or older

An overweight adult with another risk factor

Obtain: A1C or FPG or 2-hour plasma glucose post 75-g oral glucose challenge

Repeat testing every 3 years.

American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.


Diagnostic criteria for pre diabetes and diabetes

Diagnostic Criteria for Pre-diabetes and Diabetes

American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.


National diabetes education program materials

National Diabetes Education Program Materials


Game plan

GAME PLAN


Game plan1

GAME PLAN

Health Care Professional Toolkit


Ndep diabetes prevention materials

NDEP Diabetes Prevention Materials


Ndep campaign tools at www yourdiabetesinfo org

NDEP Campaign Tools at www.YourDiabetesInfo.org

TV, radio, and print PSAs

Sample feature articles

Sample press releases and media advisories

Fact sheets

Web buttons/blurbs

NDEP logos and banners


For more information about ndep and to order free diabetes materials

For more information about NDEP and to order free diabetes materials:

Call 1-888-693-NDEP (1-888-693-6337)

Or Click www.YourDiabetesInfo.org

The U.S. Department of Health and Human Services’ National Diabetes Education Program is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations.


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