Chapter 5. Prevention of Type 2 and Gestational Diabetes

  1. William H. Herman2,
  2. Ann Louise Kinmonth3,
  3. Nicholas J. Wareham4 and
  4. Rhys Williams5
  1. Richard F. Hamman and
  2. Dana Dabelea

Published Online: 12 JAN 2010

DOI: 10.1002/9780470682807.ch5

The Evidence Base for Diabetes Care, Second Edition

The Evidence Base for Diabetes Care, Second Edition

How to Cite

Hamman, R. F. and Dabelea, D. (2010) Prevention of Type 2 and Gestational Diabetes, in The Evidence Base for Diabetes Care, Second Edition (eds W. H. Herman, A. L. Kinmonth, N. J. Wareham and R. Williams), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470682807.ch5

Editor Information

  1. 2

    Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA

  2. 3

    General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

  3. 4

    MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

  4. 5

    School of Medicine, Swansea University, Swansea, UK

Author Information

  1. Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO, USA

Publication History

  1. Published Online: 12 JAN 2010
  2. Published Print: 19 FEB 2010

ISBN Information

Print ISBN: 9780470032749

Online ISBN: 9780470682807

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Keywords:

  • primary prevention;
  • primordial prevention;
  • gestational diabetes mellitus;
  • type 2 diabetes mellitus;
  • lifestyle;
  • physical activity;
  • pharmacological agents;
  • diet;
  • hyperglycaemia;
  • prediabetes;
  • cost-effectiveness

Summary

This chapter systematically reviews the available evidence that type 2 diabetes mellitus and gestational diabetes (GDM) can be prevented or delayed. There is now conclusive evidence that lifestyle modification, especially with modest weight loss and increased physical activity, can delay or prevent type 2 diabetes in adults. Most studies suggest that this can be done in cost-effective ways. Similarly, metformin therapy for high-risk subjects with prediabetes is also effective. Other classes of pharmacological agents are reviewed for which there is limited evidence of efficacy for type 2 diabetes prevention. There have been no randomized prevention trials for GDM; however, there is suggestive observational evidence that it may also be reduced with lifestyle modification. Approaches to reduction of the risk factors for type 2 and GDM (primordial prevention) are also reviewed and there is accumulating evidence that community, worksite and school based interventions are beginning to show promise, although much work remains