Clinical Practice Guidelines:

Management of
Type 2 Diabetes Mellitus
(4th Edition) 2009

Topic 3:
Prevention of Diabetes

Scientific Evidence
There is evidence that interventions can
reduce the conversion of IFG/IGT to frank
T2DM
Da Qing IGT & Diabetes Study (China)
Diabetes Prevention Study (Finland)
Diabetes Prevention Program (USA)
STOP NIDDM (Europe, Canada)
Troglitazone in the Prevention of Diabetes /
TRIPOD (USA)
2

Scientific Evidence (cont.)

Study

Reduction in Risk (%)

Lifestyle

Drug

31-46

DPS

58

DPP

58

31

Stop NIDDM

25

TRIPOD

55

Da Qing

Intervention
Diet and physical activity are the mainstay of
therapy.
Weight loss remains a priority in prevention of
T2DM
In addition, Metformin should be considered:
Those at very high risk (combined IFG & IGT, plus
other risk factors)
Fail lifestyle therapy after 6 months

Intervention (cont.)
Other pharmacological agents than can be used:
Acarbose
Orlistat
Rosiglitazone

All the above drugs off label use

Use of other agents (ACE-Is, ARBs and statins
are not recommended solely for the purpose of
primary prevention)

Individual at risk
Those at risk include those with IGT or IFG but
also those with:

Family history of diabetes (1st degree relatives)

GDM
Hypertension
Vascular disease
Dyslipidaemia
Obesity/overweight with central obesity
PCOS
6

Summary
In individuals with IGT, a structured
program of lifestyle modification that
includes moderate weight loss and regular
physical activity has been shown to
reduce the risk of T2DM

Thank you