Steps Toward the Meaningful Translation of Prevention Strategies for Type 2 Diabetes

As a scientific and medical community, we are clearly in a position to take the next logical steps toward the ultimate goal to reduce progression to type 2 diabetes for our populations at risk. One can argue that we no longer need to debate on the incredible increase in obesity and in new cases of type 2 diabetes occurring worldwide. According to the Centers for Disease Control and Prevention, 35% of U.S. adults aged 20 years or older may have prediabetes. When this statistic is applied to the entire U.S. population in 2010, it would suggest that prediabetic states exist in an estimated 79 million Americans aged 20 years or older (1). In addition, it is well recognized that because of both the associated comorbidities and complications and the costs associated with the care of the disease, diabetes will continue to represent one of the major health issues that we will face in the twenty-first century. Furthermore, there is no argument that the major factors contributing to the development of diabetes consist of lifestyle habits (i.e., physical inactivity and dietary intake) and obesity. It is now well documented that both lifestyle modification and metformin appear to be effective modalities in reducing the cumulative incidence of diabetes for at least 10 years (2–4). As such, evidence to date suggests that we are able to identify individuals in “prediabetic states” and that we can delay the progression to overt diabetes, at least as documented with intervention strategies tested in well-designed clinical trials. Thus, it appears that we are at a stage where we can begin discussions on implementing effective prevention strategies at a population-based level. In this regard, it is very timely that the American Diabetes Association (ADA), as part of its 2012–2015 Strategic Plan, will focus resources in the …