Editorials

Targeting people with pre-diabetes

BMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7361.403 (Published 24 August 2002) Cite this as: BMJ 2002;325:403

Lifestyle interventions should also be aimed at people with pre-diabetes

  1. K M Venkat Narayan, adjunct professor (kav4@cdc.gov),
  2. Giussepina Imperatore, medical epidemiologist,
  3. Stephanie M Benjamin, epidemiologist,
  4. Michael M Engelgau, chief, epidemiology and statistics branch.
  1. Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-10, 4770 Buford Highway NE, Atlanta, GA 30341, USA

    Three major randomised controlled trials, conducted in diverse countries, settings, and populations, confirm that effective lifestyle intervention can prevent or delay the progression to type 2 diabetes in groups at high risk, such as overweight people with impaired glucose tolerance (glucose concentration 7.8-11.1 mmol/l, two hours after a 75 g loading).13 In the largest of these trials, the diabetes prevention programme in the United States, a lifestyle modification programme was delivered with the goals of at least a 7% weight loss and at least 150 minutes of physical activity per week.4 At 24 weeks, 50% of the participants in the lifestyle intervention group had achieved the weight loss goal and 74% had achieved the activity goal. In this trial, lifestyle intervention reduced the incidence of diabetes by 58%, and one case of diabetes was prevented for every 6.9 people treated for three years.3

    In response to this impressive evidence, the American Diabetes Association's position statement on prevention of diabetes has recommended screening to detect people with impaired glucose tolerance or impaired fasting glucose (fasting …

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