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Prim Care Diabetes. 2007 Feb;1(1):5-11. doi: 10.1016/j.pcd.2006.11.001. Epub 2006 Dec 29.

Is prevention of Type-2 diabetes feasible and efficient in primary care? A systematic PubMed review.

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Institute of Public Health, Department of General Practice, University of Aarhus, Denmark.



To answer: (1) Do we have effective treatments to improve prognosis for those identified at risk of Type-2 diabetes? (2) Will prevention be cost-effective?


A systematic search was done in PubMed using the following search strategy: "diabetes AND prevention AND (IFG OR IGT)". Restrictions were: "English, Meta-Analysis, Randomized Controlled Trial, Review, Humans".


Few randomised controlled preventive trials were found. Almost all were done in research settings in people with high risk of developing Type-2 diabetes. It seems possible to either delay or prevent Type-2 diabetes through lifestyle interventions and medication. Cost-utility analyses are few in number and come to very different conclusions as to whether health policy should promote prevention of Type-2 diabetes.


Intervention studies using lifestyle counselling and drug therapy in research settings illustrate promising results with lowering of the incidence of Type-2 diabetes, meaning that Type-2 diabetes can be delayed or prevented. It is, however, questionable whether these interventions are cost-effective. We need studies in routine clinical settings evaluating morbidity, mortality and cost-effectiveness as primary outcomes. While waiting for these studies to prove cost-effective, patients with pre-diabetes should be treated according to their 10-year risk of cardiovascular disease following present guidelines.

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