Diabetes Prevention Recommendations- Risk, Fasting Glucose, Intervention, levels of glucose, physical activity, prevention

prevention The Community Prevention Services Task Force recommends that healthcare systems and communities provide counseling and longitudinal support to individuals who are at increased risk for type 2 diabetes. some tips and full text can be found here. 

First the verbatim abstract is as under:

Description: This release is an essential part of the Community Preventive Services Task Force (Task Force) recommendation on the use of combined diet and physical activity promotion programs to reduce progression to type 2 diabetes in persons at increased risk.

Methods: The Task Force commissioned an evidence review of the assessed, benefits and harms of programs to promote and support individual improvements in diet, exercise, and weight and supervised a review on the economic efficiency of these programs in clinical trial, primary care, and primary care–referable settings.

Population: Mainly society groups -Adolescents and adults at increased risk for progression to type 2 diabetes were a part.

Recommendation: The Task Force recommends the use of combined diet and physical activity promotion programs by health care systems, communities, and other implementers to provide counseling and support to clients identified as being at increased risk for type 2 diabetes. Economic evidence indicates that these programs are cost-effective.

Summary of Recommendations and Evidence

The Task Force recommends combined diet and physical activity promotion programs for persons at increased risk for type 2 diabetes on the basis of strong evidence of effectiveness in reducing new-onset diabetes. Combined diet and physical activity promotion programs also increase the likelihood of reversion to normoglycemia and improve diabetes and cardiovascular disease risk factors (weight, blood glucose levels, blood pressure, and lipid levels). These programs are effective across a range of counseling intensities, settings, and implementers. Programs commonly include a weight-loss goal, individual or group sessions (or both) about diet and exercise, meetings with a trained diet or exercise counselor (or both), and individually tailored diet or exercise plans (or both). Higher-intensity programs lead to greater weight loss and reduction in new-onset diabetes.

Economic evidence indicates that such programs aimed at preventing type 2 diabetes among persons at increased risk are cost-effective. A summary of the Task Force findings and rationale can be found at www.thecommunityguide.org/diabetes/combineddietandpa.html.

Target Population

Program participants may be considered at increased risk for type 2 diabetes if they have blood glucose levels that are abnormally elevated but not high enough to be classified as type 2 diabetes (1). Persons at increased risk have hemoglobin A1c levels between 5.7% and 6.4%, fasting plasma glucose levels between 100 and 125 mg/dL, or plasma glucose levels between 140 and 199 mg/dL after a 75-g oral glucose tolerance test. In some programs, validated predictive tools, such as the Finnish Diabetes Risk Score, may be used to identify persons at increased risk.

Combined diet and physical activity promotion programs actively encourage persons who are at increased risk for diabetes to improve their diet and increase their physical activity. Critical components include the following:

• Trained providers in clinical or community settings who work directly with program participants for at least 3 months

• Some combination of counseling, coaching, and extended support

• Multiple sessions related to diet and physical activity, delivered in person or by other methods

Programs may also use 1 or more of the following:

• Diet counselors in different specialties (for example, nutritionists, dietitians, or diabetes educators), exercise counselors in different specialties (for example, physical educators, physiotherapists, or trainers), physicians, nurses, and trained laypersons

• A range of intensity of counseling, with many or few sessions, longer- or shorter-duration sessions, and individual or group sessions

• Individually tailored or generic diet or physical activity programs

• Specific weight-loss or exercise goals

• A period of maintenance sessions after the primary core period of the program

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