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The Science: Type 2 Diabetes Prevention

The Science: Type 2 Diabetes Prevention. The DPP was a major clinical trial to determine whether diet and exercise or the oral diabetes drug metformin could prevent or delay the onset of type 2 diabetes. DPP Research Group. N Engl J Med 2002, Vol.346, No. 6. Diabetes Prevention Program (DPP).

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The Science: Type 2 Diabetes Prevention

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  1. The Science: Type 2 Diabetes Prevention

  2. The DPP was a major clinical trial to determine whether diet and exercise or the oral diabetes drug metformin could prevent or delay the onset of type 2 diabetes. DPP Research Group. N Engl J Med 2002, Vol.346, No. 6. Diabetes Prevention Program (DPP)

  3. DPP Participants Adults at high risk for type 2 diabetes Presence of IGT Mean age 51 years Mean body mass index (BMI) 34 68% women 45% minority groups African Americans Hispanics/Latinos American Indians Asian Americans and Pacific Islanders DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.

  4. DPP Methods Lifestyle intervention 5% to 7% weight reduction Healthy low-calorie, low-fat diet 30 minutes of physical activity, 5 days a week Metformin Oral diabetes drug Placebo DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.

  5. DPP Methods DPP Curriculum: Diet Exercise Behavior change modification Taught one-on-one by case managers DPP Research Group. N Engl J Med 2002, Vol.346, No. 6.

  6. Diabetes Prevention Program Outcomes Study (DPPOS) Follow-up study to the DPP Assess the long-term effects of the DPP interventions on the development of type 2 diabetes and its complications

  7. Diabetes Prevention Program Outcomes Study (DPPOS) After 10 years’ follow up, lifestyle intervention: reduced the rate of developing type 2 diabetes by 34% reduced the rate of developing type 2 diabetes by 49% in those age 60 and older delayed type 2 diabetes by about 4 years reduced cardiovascular risk factors Reduced A1C and FPG DPP Research Group. The Lancet 2009: Vol.374, No. 9702.

  8. Diabetes Prevention Program Outcomes Study (DPPOS) At 10 years’ follow up, metformin reduced the rate of developing diabetes by 18% compared with placebo. delayed diabetes by 2 years compared with placebo. reduced A1C and fasting glucose compared with placebo. DPP Research Group. The Lancet 2009: Vol.374, No. 9702.

  9. Diabetes Prevention Program Outcomes Study (DPPOS) Preliminary results 8% of participants with pre-diabetes had diabetic eye disease (retinopathy) 12.6% of participants with type 2 diabetes who developed diabetes during the DPP had diabetic eye disease These findings suggest that patients with pre-diabetes or newly diagnosed type 2 diabetes should be screened for retinopathy. DPP Research Group. Diabetic Medicine 2007; 24 (2); 137-144.

  10. Diabetes Prevention 79 million U.S. adults ages 20 and older have pre-diabetes National Diabetes Fact Sheet, CDC, 2011. http://www.cdc.gov/diabetes/pubs/factsheet11.htm

  11. What is Pre-diabetes? Pre-diabetes is a medical condition where blood glucose is higher than normal but not high enough to be diagnosed as diabetes It increases the risk for type 2 diabetes and cardiovascular disease Most people have pre-diabetes before they develop type 2 diabetes American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.

  12. What is Pre-diabetes? Most people with pre-diabetes develop type 2 diabetes within 10 years People with pre-diabetes are identified by having a screening test which shows they have IFG, IGT or an A1C of 5.7% - 6.4% Progression to diabetes is NOT inevitable American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.

  13. History of vascular disease Signs of insulin resistance (such as PCOS or acanthosisnigricans) Pre-diabetes Inactive lifestyle American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61. Risk Factors for Diabetes • Age 45 and older • Overweight (BMI ≥ 25) • Hypertension • Abnormal lipid levels • Family history of diabetes • Race/ethnicity • History of gestational diabetes

  14. Testing for Diabetes and Pre-Diabetes Consider testing if person is: Age 45 or older An overweight adult with another risk factor Obtain: A1C or FPG or 2-hour plasma glucose post 75-g oral glucose challenge Repeat testing every 3 years. American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.

  15. Diagnostic Criteria for Pre-diabetes and Diabetes American Diabetes Association. Diabetes Care 2011; 34;(Suppl.1):S11-61.

  16. National Diabetes Education Program Materials

  17. GAME PLAN

  18. GAME PLAN Health Care Professional Toolkit

  19. NDEP Diabetes Prevention Materials

  20. NDEP Campaign Tools at www.YourDiabetesInfo.org TV, radio, and print PSAs Sample feature articles Sample press releases and media advisories Fact sheets Web buttons/blurbs NDEP logos and banners

  21. For more information about NDEP and to order free diabetes materials: Call 1-888-693-NDEP (1-888-693-6337) Or Click www.YourDiabetesInfo.org The U.S. Department of Health and Human Services’ National Diabetes Education Program is jointly sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention with the support of more than 200 partner organizations.

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