Benefit of lifestyle-based T2DM prevention is influenced by prediabetes phenotype

• Published in: Nature reviews. Endocrinology Vol. 16; no. 7; pp. 395 - 400
• Main Authors: Campbell, Matthew D., Sathish, Thirunavukkarasu, Zimmet, Paul Z., Thankappan, Kavumpurathu R., Oldenburg, Brian, Owens, David R., Shaw, Jonathan E., Tapp, Robyn J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-07-2020; Nature Publishing Group
• Subjects: 692/163/2743/2815; 692/699/2743/137/773; 692/700/2817; 692/700/459/284; Blood Glucose - metabolism; Chromium; Dextrose; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - prevention & control; Endocrinology; Fasting; Genetic aspects; Genotype & phenotype; Glucose; Glucose Intolerance - etiology; Glucose Intolerance - pathology; Glucose Intolerance - therapy; Glucose tolerance; Health risk assessment; Humans; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - therapy; Life Style; Lifestyles; Medicine; Medicine & Public Health; Perspective; Phenotype; Phenotypes; Prediabetic state; Prediabetic State - blood; Prediabetic State - pathology; Prediabetic State - therapy; Prevention; Risk Factors; Risk Reduction Behavior; Treatment Outcome; Type 2 diabetes; Australia; United Kingdom; India
• ISSN: 1759-5029; 1759-5037
• DOI: 10.1038/s41574-019-0316-1

The prevention of type 2 diabetes mellitus (T2DM) is a target priority for the WHO and the United Nations and is a key priority in the 2018 Berlin Declaration, which is a global call for early actions related to T2DM. Health-care policies advocate that individuals at high risk of developing T2DM undertake lifestyle modification, irrespective of whether the prediabetes phenotype is defined by hyperglycaemia in the postprandial state (impaired glucose tolerance) and/or fasting state (impaired fasting glucose) or by intermediate HbA
1c
levels. However, current evidence indicates that diabetes prevention programmes based on lifestyle change have not been successful in preventing T2DM in individuals with isolated impaired fasting glucose. We propose that further research is needed to identify effective lifestyle interventions for individuals with isolated impaired fasting glucose. Furthermore, we call for the identification of innovative approaches that better identify people with impaired glucose tolerance, who benefit from the currently available lifestyle-based diabetes prevention programmes.
Prediabetes phenotype can influence the effectiveness of lifestyle intervention-based diabetes prevention programmes. This Perspectives suggests that diabetes prevention programmes are not effective in individuals with isolated impaired fasting glucose and calls for further research to improve prevention of type 2 diabetes mellitus in this population.