Supervisors info:
Μπενέτου Βασιλική, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Τεντολούρης Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κόκκινος Αλέξανδρος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Objective: Type 2 diabetes mellitus (T2D) is one of the fastest evolving public health threats worldwide. Prevention of T2D at the level of primary health care is extremely important. The aim of this study was to collect and summarize international guidelines for T2D prevention targeting specific issues. Methods: Medline and Google databases were searched to find the international guidelines published from 2013 until today, in English. The findings were synthesized to answer questions focused on disease prevention at primary care level, namely: a) screening, b) lifestyle changes and c) drug therapy. Results: In total, the guidelines of 9 scientific societies and expert groups were analyzed. The recommendations were found to converge on the key points. T2D screening assesses risk factors for developing the disease and is tested using fasting plasma glucose and/or glycosylated haemoglobin (in certain countries) every three years. Physical activity and exercise are recommended as preventive measure by all scientific societies mainly in the form of mild aerobic exercise. Regarding weight loss in overweight/obese people, the overall goal ranges from 5-7% of total weight. For nutrition, the main messages concern the consumption of minimally processed foods of plant origin, such as whole grains, vegetables, fruits, legumes, nuts, while at the same time it is recommended to consume minimal red meats and avoid processed meats, sodium, sugary drinks and refined cereals. Metformin is preferred in medication in people who have a BMI of > 35 kg/m2, under the age of 60 years, as well as in women with previous diabetes mellitus gestation, mainly in American and Canadian recommendations. Conclusions: According to existing studies, there is sufficient evidence that type 2 diabetes can be prevented. Primary care physicians can implement the guidelines taking into account the specific needs of each patient, so that each person enjoys the care they deserve with the best possible results.
