Chapter 7. Missed and Newly Recovered Potential for the Prevention of Type 2 Diabetes: A Commentary

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. Jaakko Tuomilehto

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch7

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Tuomilehto, J. (2002) Missed and Newly Recovered Potential for the Prevention of Type 2 Diabetes: A Commentary, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch7

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Department of Public Health, University of Helsinki, Mannerheimintie 166, 00300 Helsinki, Finland

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • screening;
  • cardiovascular disease;
  • cancer;
  • epidemiology;
  • treatment;
  • diagnosis;
  • hyperglycaemia;
  • ecological fallacy;
  • genetic factor;
  • lifestyle change

Summary

Primary prevention of type 2 diabetes was proposed by Dr E Joslin in the early 1900s but received very little attention for the ensuing 90 years. While cardiovascular disease and cancer, as diseases with an associated high mortality, were the subject of epidemiological investigations, such research into diabetes developed much more slowly. The lack of epidemiological data on diabetes hampered the development of public health applications related to diabetes. At the start of the 21st century, no country has yet outlined a strategy for the prevention of type 2 diabetes. Problems to be faced include difficulties in diagnosing diabetes and in defining hyperglycaemia, controlling for environmental and cultural effects in different populations, unravelling the polygenic influences and deciding at what age to intervene. Studies in Finland and the US have shown that lifestyle changes can prevent type 2 diabetes in high-risk subjects. The challenge now is to develop a successful intervention strategy that will extend this to all individuals at risk.