Prevention of Type 2 Diabetes

Abstract

Diabetes is defined by elevated plasma glucose concentrations and characterized by metabolic disturbances and widespread tissue damage. Diagnostic criteria and classification of types of diabetes and the risk factors for T2DM are described in other chapters of this book. This chapter considers only T2DM. Diagnostic cut-points for diabetes have often been chosen to correspond to degrees of hyperglycemia associated with diabetes complications, usually retinopathy or nephropathy. Thus, it is widely believed that preventing increases in hyperglycemia to levels that are diagnostic of diabetes and associated with development of complications will also prevent development of the complications. It is also hypothesized that preventing diabetes complications is more feasible in this way than by postponing interventions until the disease is diagnosed, at which time some tissue damage may have already occurred and hyperglycemia may be more difficult to control. While these are very natural assumptions, evidence supporting them has been difficult to obtain. The assumption that preventing T2DM will also prevent its complications provides the main justification for the concept that it is better to prevent diabetes than to wait until it develops and then treat it.