Early diagnosis and prevention of Diabetes

Early diagnosis of Diabetes

Diabetes and pre-diabetes usually are not symptomatic in most cases and such diagnosis could be delayed to around 10 years if not appropriately screened. We know that one third to one half of all the cases with diabetes are not aware that they have the disease. On a global scale, this translates to around 100 million not aware of the disease and may already have complications at the time of diagnosis. For pre-diabetes, there are approximately 314 million people and is expected to rise to 500 million cases by 2025.

Although mass screening to communities have been controversial in term of benefits outcome, screening for those high risk groups have been shown to be cost effective and beneficial. Those with pre-diabetes could delay the onset of diabetes or revert back to normal by appropriate intervention.

Diabetes prevention

There is substantial evidence in the literature to support that lifestyle changes can prevent or delay the onset of type 2 diabetes among those at high-risk. Those studies included people with pre-diabetes and other characteristics for developing diabetes like obesity, high lipids, hypertension, family history of diabetes, mothers who had gestational diabetes or large babies and people of certain ethnic background. The lifestyle interventions included diet and moderate intensity physical activity (such as walking for two-and-half hours each week). In the diabetes prevention program, a large prevention study of people at high risk for diabetes, the development of diabetes was reduced by 58 per cent over three years.

Studies have also shown that medications have been successful in preventing diabetes in some population groups. In the diabetes prevention program, people treated with the drug metformin reduced their risk of developing diabetes by 31 per cent over three years. The treatment with metformin was most effective among younger, heavier people and less effective among older people and those who were not as overweight. Similarly, in the STOP-NIDDM trial, treatment of people with pre-diabetes with the drug acarbose reduced their risk of developing diabetes by 25 per cent over three years.

Other studies were done with similar results in preventing the progression to diabetes and also may revert from pre-diabetes to normal glucose tolerance. Lifestyle was better and stronger than medications in achieving such results.

DIABETES MELLITUS