Ερευνητικό υλικό ΕΚΠΑ

A European evidence-based guideline for the prevention of type 2 diabetes

Αγγλικά

Background: The prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide. Aims: This guideline provides evidence-based recommendations for preventing T2DM. Methods: A European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria. Results: Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number-needed-to-treat: 6.4 over 1.84.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by 5% lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective. Conclusions: Prevention using lifestyle modifications in high-risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication. © Georg Thieme Verlag KG Stuttgart - New York.

2010

Paulweber, B.
Valensi, P.
Lindström, J.
Lalic, N.M.
Greaves, C.J.
McKee, M.
Kissimova-Skarbek, K.
Liatis, S.
Cosson, E.
Szendroedi, J.
Sheppard, K.E.
Charlesworth, K.
Felton, A.-M.
Hall, M.
Rissanen, A.
Tuomilehto, J.
Schwarz, P.E.
Roden, M.
Paulweber, M.
Stadlmayr, A.
Kedenko, L.
Katsilambros, N.
Makrilakis, K.
Kamenov, Z.
Evans, P.
Gilis-Januszewska, A.
Lalic, K.
Jotic, A.
Djordevic, P.
Dimitrijevic-Sreckovic, V.
Hühmer, U.
Kulzer, B.
Puhl, S.
Lee-Barkey, Y.H.
Alkerwi, A.
Abraham, C.
Hardeman, W.
Acosta, T.
Adler, M.
Barengo, N.
Barengo, R.
Boavida, J.M.
Charlesworth, K.
Christov, V.
Claussen, B.
Cos, X.
Cosson, E.
Deceukelier, S.
Dimitrijevic-Sreckovic, V.
Djordjevic, P.
Evans, P.
Felton, A.-M.
Fischer, M.
Gabriel-Sanchez, R.
Gilis-Januszewska, A.
Goldfracht, M.
Gomez, J.L.
Hall, M.
Handke, U.
Hauner, H.
Herbst, J.
Hermanns, N.
Herrebrugh, L.
Huber, C.
Hühmer, U.
Huttunen, J.
Jotic, A.
Kamenov, Z.
Karadeniz, S.
Katsilambros, N.
Khalangot, M.
Kissimova-Skarbek, K.
Köhler, D.
Kopp, V.
Kronsbein, P.
Kulzer, B.
Kyne-Grzebalski, D.
Lalic, K.
Lalic, N.
Landgraf, R.
Lee-Barkey, Y.H.
Liatis, S.
Lindström, J.
Makrilakis, K.
McIntosh, C.
McKee, M.
Mesquita, A.C.
Misina, D.
Muylle, F.
Neumann, A.
Paiva, A.C.
Pajunen, P.
Paulweber, B.
Peltonen, M.
Perrenoud, L.
Pfeiffer, A.
Pölönen, A.
Puhl, S.
Raposo, F.
Reinehr, T.
Rissanen, A.
Robinson, C.
Roden, M.
Rothe, U.
Saaristo, T.
Scholl, J.
Schwarz, P.E.
Sheppard, K.E.
Spiers, S.
Stemper, T.
Stratmann, B.
Szendroedi, J.
Szybinski, Z.
Tankova, T.
Telle-Hjellset, V.
Terry, G.
Tolks, D.
Toti, F.
Tuomilehto, J.
Undeutsch, A.
Valadas, C.
Valensi, P.
Velickiene, D.
Vermunt, P.
Weiss, R.
Wens, J.
Yilmaz, T.

Hormone and Metabolic Research

Georg Thieme Verlag

42

SUPPL. 1

S3-S36

acarbose; antiobesity agent; antiretrovirus agent; asparaginase; atypical antipsychotic agent; beta adrenergic receptor blocking agent; danazol; diazoxide; glipizide; glucocorticoid; glucose; gonadorelin agonist; hemoglobin A1c; high density lipoprotein cholesterol; immunosuppressive agent; low density lipoprotein cholesterol; metformin; nicotinic acid; pentamidine; phenformin; pioglitazone; placebo; ramipril; rimonabant; rosiglitazone; tetrahydrolipstatin; thiazide diuretic agent; troglitazone; unindexed drug; unsaturated fatty acid, abdominal obesity; angioneurotic edema; bariatric surgery; cardiovascular risk; cholesterol blood level; clinical practice; clinical trial; comorbidity; cost effectiveness analysis; coughing; depression; diabetic patient; dietary intake; drug withdrawal; ethnicity; Europe; evidence based medicine; exercise; food intake; gastrointestinal symptom; genetic predisposition; glucose blood level; glucose homeostasis; health care planning; health promotion; heart failure; hemoglobin blood level; high risk patient; high risk population; human; Human immunodeficiency virus infection; hypoglycemia; immobilization; impaired glucose tolerance; insulin resistance; kinesiotherapy; leisure; lifestyle modification; lipoprotein blood level; metabolic syndrome X; methodology; non insulin dependent diabetes mellitus; obesity; oral glucose tolerance test; ovary polycystic disease; physical activity; practice guideline; pregnancy diabetes mellitus; prematurity; prenatal development; priority journal; questionnaire; review; risk factor; screening; sensitivity and specificity; social status; social support; systematic review; weight reduction; adult; Diabetes Mellitus, Type 2; economics; evidence based medicine; health care planning; lifestyle; mass screening, Adult; Diabetes Mellitus, Type 2; Europe; Evidence-Based Medicine; Health Planning Guidelines; Humans; Life Style; Mass Screening; Risk Factors

https://doi.org/10.1055/s-0029-1240928

10.1055/s-0029-1240928

https://pergamos.lib.uoa.gr/uoa/dl/object/3089075