Last update:
15-Jul-2011

Type 2 diabetes mellitus (DM) is the most costly chronic disease for both the individual and society. Its micro- and macro-vascular complications constitute a major cause of morbidity and mortality. Additional genetic variants interact with various environmental factors in the development of this complex multi-genetic disorder. Various major diabetes prevention trials based on lifestyle and/or medical interventions in high-risk individuals have shown that the process of its natural history, from the preclinical phase of impaired glucose regulation to the appearance of clinical DM, can be stopped. This involves important applications in primary health care. According to the results of the prevention trials, the interventions changing dietary habits and increasing physical activity are the most effective strategies, and should be the first steps in type 2 DM prevention programs. Interventions with administration of drugs such as metformin, acarbose and orlistat also appear effective, but as a second choice, taking into account their side effects and contraindications. Many countries have begun to implement strategies for primary prevention of type 2 DM, although the cost-effectiveness of the models and strategies used have not yet evaluated. The development and implementation of national policies for the prevention of type 2 DM with optimum efficiency and minimum cost is the only way to reduce the personal and socio-economic burden of this disease and its complications.

Key words: Impaired glucose tolerance, Nutritional interventions, Prevention, Primary health care, Type 2 diabetes mellitus.