Preventing type 2 diabetes: what have we learned?

The substantial burden of morbidity and mortality associated with type 2 diabetes and the high costs associated with the management of diabetic complications highlight the need for the development of strategies for the prevention of diabetes. Impaired glucose tolerance is a pre-diabetic state which may present an opportunity for intervention to prevent the onset of clinical diabetes. Four recent clinical trials, the DPP, the FDPS, the STOP-NIDDM and the Da Qing study, have evaluated interventions based on diet and exercise and/or pharmacotherapy in pre-diabetic subjects. In all these trials the intervention strategies significantly reduced the incidence of diabetes. A worldwide epidemic of type 2 diabetes will occur over the coming decades and translating the results of these studies into practical and effective initiatives for diabetes prevention is an urgent clinical priority.Br J Diabetes Vasc Dis 2003;3(suppl 1):S6—S11