Rethinking the Goals of Diabetes Prevention Programs

作者：Briana Mezuk, Julie Ober Allen · 发表于：Diabetes Care · 年份：2021 · DOI：10.2337/dci21-0038 · 被引用次数：15 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Obesity and Health Practices、Diabetes Management and Education

In September 2001, the Centers for Disease Control and Prevention (CDC) issued a press release stating that “twin epidemics of diabetes and obesity continue to threaten the health of Americans” but that encouraging new studies (i.e., the Diabetes Prevention Program [DPP] experimental trial) indicated that type 2 diabetes could be prevented and that “promoting healthy lifestyles should be a national priority” (1). Twenty years later, this press release could be issued today with almost no revision and be completely accurate. In 2001, 6.4% of the U.S. population had diagnosed diabetes; currently 10.5% of Americans do (2). Today’s prevalence closely matches projections made in 1992 based on “the overly pessimistic assumption that there will be no scientific or medical discoveries to reduce the prevalence of diabetes” (3). Yet, strategies for preventing diabetes have been developed in the intervening years. In 2001, the DPP made history as one of a handful of clinical trials that was stopped early because the risk-benefit ratio so clearly favored the experimental interventions over placebo (4). This remarkable efficacy buoyed support for wide-scale implementation of the DPP “lifestyle” arm, which had the goals of promoting ≥5% weight loss and ≥150 min of weekly physical activity. Achievement of these two goals was demonstrated in the DPP trial to significantly reduce type 2 diabetes risk short-term (within 5 years). Enthusiasm for the DPP trial sharply contrasted with the chall...