he causes of
type 1 diabetes
are under investigation, and researchers are working to
learn how to prevent the disease. While the causes of
type 2 diabetes
are not well understood,
recent research has demonstrated that it often can be prevented or delayed through lifestyle
changes in at risk persons.(42) This section focuses on the prevention of type 2 diabetes. The
"Treatment" section within this document addresses the prevention of medical complications
caused by diabetes.
The prevalence
of diagnosed type 2
diabetes increased sixfold
in the latter half of
the past century.(43)
Obesity and physical
inactivity have played a
major role in this
dramatic increase in rates
of type 2 diabetes.(44) For
example, until recently
type 2 diabetes was not
frequently seen in
school-aged children and
adolescents. Now the
prevalence of type 2
diabetes for persons 20 and under appears to be rising considerably, and this rise can be
attributed to increases in physical inactivity and excess weight gain.45 More than one-third of
young people in grades 9-12 do not regularly engage in vigorous activity (Figure 8 [Ed: not reproduced here]).(46)
Vigorous activity is defined as sustained activity that results in a significant increase in heart and
breathing rate.(47)
The
Diabetes Prevention Program (DPP)-a major clinical trial involving 3,234 people
with impaired glucose tolerance, a condition that often precedes diabetes-demonstrated that
some people at high risk for type 2 diabetes can prevent or delay the onset of the disease by
losing 5 percent to 7 percent of their body weight and getting 30 minutes or more of physical
activity at least 5 days per week.48 In this study, the development of type 2 diabetes was reduced
by 58 percent over a three-year period. This benefit was seen in participants of all ages and racial
and ethnic backgrounds. The very encouraging results of this trial show that it is possible to
prevent or delay type 2 diabetes in high-risk persons.
It is not easy for many people to lose weight and increase their physical activity.
However, it is imperative to build upon the results of the DPP and encourage people to take the
necessary steps to prevent type 2 diabetes. This not only will help many Americans live
healthier, more productive lives, but it also has the potential to save billions of dollars in health
care costs associated with hospitalizations for diabetes and its complications. Friends, families,
schools, health care providers, work sites and communities all can contribute in important ways
to support healthier lifestyles.
42 Diabetes Prevention Program Research Group, op.cit.
43 Centers for Disease Control and Prevention (CDC). (2001). Diabetes: A serious public health problem. Atlanta,
GA: Department of Health and Human Services.
44 CDC, op.cit., Promising practices in Chronic Disease.
45 ibid.
46 Kann L, et al. (2000). Youth Risk Behavior Surveillance Survey - US 1999, in CDC surveillance survey.
MMWR, 49(SS-5), 1-96.
47 Centers for Disease Control and Prevention (CDC). Physical Activity Terms. Available at:
http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm#Vigorous. Accessed September 15, 2004.
48 Diabetes Prevention Program Research Group, op.cit.
From the NDEP
Dec2004
http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
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