Prevention/Delay of Type 2 Diabetes
Î Among individuals at high risk for developing type 2 diabetes,
structured programs emphasizing lifestyle changes that include
moderate weight loss (7% body weight) and regular physical activity
(150 min/week), with dietary strategies including reduced calories
and reduced intake of dietary fat, can reduce the risk for developing
diabetes and are therefore recommended. (A)
Î Individuals at high risk for type 2 diabetes should be encouraged to
achieve the US Department of Agriculture (USDA) recommendation for
dietary fiber (14 g fiber/1000 kcal) and to consume foods containing
whole grains (one-half of grain intake). (B)
Î Follow-up counseling appears to be important for success. (B)
Î Patients with IGT (A), IFG (E), or an A1c of 5.7%-6.4% (E) should be
referred to an effective ongoing support program targeting weight
loss of 7% of body weight and increasing physical activity to at least
150 minutes per week of moderate activity such as walking.
Î Based on the cost-effectiveness of diabetes prevention, such programs
should be covered by third-party payors. (B)
Î Metformin therapy for prevention of type 2 diabetes may be
considered in those with IGT (A), IFG (E), or an A1c of 5.7%-6.4% (E),
especially for those with body mass index (BMI) >35 kg/m
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, age <60
years, and women with prior GDM. (A)
Î At least annual monitoring for the development of diabetes in those
with prediabetes is suggested. (E)
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