Prevention of diabetes: Ethical consideration

doi:10.1136/bmj.333.7574.918-c

BMJ 2006;333:918 (28 October), doi:10.1136/bmj.333.7574.918-c

Letter

Prevention of diabetes

Ethical consideration

The first 100% of the full text of this article appears below.

EDITOR—Drugs to prevent the onset of diabetes in patientsat risk work. However, they seem to be less effective than intensivelifestyle interventions. The authors point to intensive programmesinvolving up to 16 one to one sessions to promote healthierbehaviour and correctly ask if those standards are economicalto offer to larger populations.¹ A further concern is whetherhealthy behaviour is maintained after active intervention hasceased. Comparing both approaches misses one point. Many patientswould opt for the soft way of taking a pill when given the choice.Financial resources in medicine all over the world are increasinglyrestricted, and rationing will ask questions about effectiveness,appropriateness, and justice. Health behaviour modificationfits all three categories, and if patients were to have no choicebut to take part in a well balanced lifestyle intervention itseffectiveness would be even greater.