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Background: The global epidemic of type 2 Diabetes Mellitus (T2DM) presents significant challenges to world health both in terms of financial costs as well as morbidity. Thus, considerable research has been focussed on the prevention or delay of the onset of T2DM. Aim: The aim of this article is to review published studies that evaluate lifestyle and pharmacological interventions aimed at preventing T2DM and to compare both these interventions. Methods: We undertook an electronic search of MEDLINE, PubMed, EMBASE and Cochrane Register of Controlled Trials, with the English language restriction and published until May 2015. Five major diabetes prevention trials using lifestyle intervention (LSI) and five using pharmacological intervention were identified. We reviewed the study design, key components, and outcomes for each study aimed to delay T2DM. Results: Both LSI and pharmacological intervention were found to be effective to reduce the risk of developing T2DM in at risk population. LSI with modest goals of weight loss and physical activity is safe, cost saving and prevents or delays the onset of diabetes, even after discontinuation of the treatment providing long term benefits. A Considerable effort from well-trained, multidisciplinary staff is needed to achieve these modest goals. For patients who are unable to achieve the lifestyle goals or those who progress to T2DM despite being on LSI, pharmacological intervention has shown to be effective, especially in younger obese patients. Adverse effects with pharmacological intervention were common. Conclusion: Strong evidence exists for the prevention or delay of type 2 diabetes through lifestyle and pharmacological intervention. LSI with weight loss and increased physical activity are safe, costeffective and are currently recommended for the prevention of diabetes. |
