title: International Diabetes Federation: An update of the evidence concerning the prevention of type 2 diabetes.
abstract: This article aims to provide an updated summary of diabetes prevention efforts by reviewing relevant literature published between 2007 and 2009. These include results from the long-term follow-up of diabetes prevention trials and the roll-out of community-based interventions in "real world" settings. Some countries have begun to implement population-based strategies for chronic disease prevention, but investment in developing and evaluating population-level interventions remains inadequate. By focussing on the "small change" approach and involving a number of different agencies, it may be possible to shift the population distribution of risk factors for diabetes and cardiovascular disease in a favourable direction. The cost-effectiveness of primary prevention strategies for type 2 diabetes has not been universally demonstrated. Some of the uncertainties relating to screening for diabetes have now been resolved but longer-term data on hard cardiovascular outcomes are still needed. In summary, individual countries should aim to develop and evaluate cost-effective, setting-specific diabetes risk identification and prevention strategies based on available resources. These should be linked to initiatives aimed at reducing the burden of cardiovascular disease, and complemented with population-based strategies focusing on the control and reduction of behavioural and cardiovascular risk factors by targeting their key determinants.
authors.affiliation: MRC Epidemiology Unit, Cambridge, UK. rebecca.simmons@mrc-epid.cam.ac.uk
authors.forename: R K
authors.initials: RK
authors.lastname: Simmons
authors.forename: N
authors.initials: N
authors.lastname: Unwin
authors.forename: S J
authors.initials: SJ
authors.lastname: Griffin
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008403:Mass Screening; D015201:Meta-Analysis as Topic; D016016:Proportional Hazards Models; D012306:Risk; D012307:Risk Factors
chemical_list: D001786:Blood Glucose