Department of Medicine, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA.
Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 6th Floor, Chicago, IL, 60611, USA.
Curr Diab Rep. 2020 Feb 20;20(3):9. doi: 10.1007/s11892-020-1293-4.
Type 2 diabetes is common, burdensome, and preventable. Landmark trials such as the Diabetes Prevention Program (DPP) demonstrated that resource-intensive lifestyle support interventions resulting in modest weight loss via healthy diet changes and physical activity can lower the rate of diabetes development by 58%. We performed a review of efforts to translate and implement DPP-like programs throughout the USA to identify challenges and opportunities for improvement.
For more than a decade, multiple stakeholders have worked to translate evidence-based principles of diabetes prevention to reach 84 million Americans with prediabetes. DPP-like programs have been delivered by over 1500 organizations, reaching almost 300,000 people, but this number represents less than 1% of the target population. Research has uncovered large gaps in efforts to diagnose, raise awareness, and provide access to DPP-like programs for adults with prediabetes, requiring further stakeholder engagement and coordination to resolve. Efforts to address prevailing gaps in diabetes prevention must address distinct and sometimes conflicting priorities and concerns of stakeholders. Our review recommends several areas of further research and action to improve type 2 diabetes prevention on a population scale.
2 型糖尿病较为常见且负担沉重，但可预防。糖尿病预防计划（DPP）等里程碑式试验表明，通过健康饮食改变和身体活动实现适度体重减轻的资源密集型生活方式支持干预措施，可使糖尿病发病率降低 58%。我们对美国各地翻译和实施类似 DPP 项目的努力进行了回顾，以确定改进的挑战和机会。
十多年来，多个利益相关者一直致力于将糖尿病预防的循证原则转化，以覆盖 8400 万患有前驱糖尿病的美国人。已有 1500 多个组织提供了类似 DPP 的项目，覆盖近 30 万人，但这一数字不到目标人群的 1%。研究发现，在诊断、提高认识和为前驱糖尿病成年人提供类似 DPP 的项目方面，努力存在很大差距，需要进一步利益相关者的参与和协调来解决。解决糖尿病预防方面的普遍差距，必须解决利益相关者不同且有时相互冲突的优先事项和关注点。我们的综述建议在人群层面进一步开展研究和采取行动，以改善 2 型糖尿病的预防。
