Prevention of diabetes mellitus type 2

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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]

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".[2][3]

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.[4][5][6] 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.[7][8]

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".[9]

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.[10]

High levels of dietary trans-palmitoleic acid (a fatty acid naturally occurring in milk and other dairy products) were found strongly correlated with reduced risk of type 2 diabetes and reduced cardiovascular risk markers.[11] Overall milk consumption may have a beneficial effect.[12]

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.[13]

Medications

Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin,[5] rosiglitazone,[14] or valsartan.[15]

Lifestyle interventions are however more effective than metformin at preventing diabetes regardless of weightloss.[16]

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.[17] 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. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  3. evidence report
  4. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  5. 5.0 5.1 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  6. Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/S0140-6736(09)61457-4, please use {{cite journal}} with |doi=10.1016/S0140-6736(09)61457-4 instead.
  7. Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18165339, please use {{cite journal}} with |pmid=18165339 instead.
  8. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  9. 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.CS1 maint: multiple names: authors list (link)
  10. 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.CS1 maint: multiple names: authors list (link)
  11. Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 21173413, please use {{cite journal}} with |pmid=21173413 instead.
  12. 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.CS1 maint: multiple names: authors list (link)
  13. 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.CS1 maint: multiple names: authors list (link)
  14. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  15. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  16. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  17. 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. Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
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