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Europe unveils comprehensive diabetes prevention strategy

A large team of European researchers, clinicians, and other health experts has presented broad new guidelines for the prevention of type 2 diabetes in Europe, part of an effort to recast the disease as a public-health priority.

The inveThe guidelines, presented April 9 at a diabetes conference in Dresden, Germany, and to be published in a supplement to Hormone and Metabolic Research, came as a result of the IMAGE project, a diabetes-prevention effort launched in 2007 with a 1.2 million € grant from the European Union.

As in other affluent, industrialized regions with automobile-dependent lifestyles, diabetes is of increasing concern in the EU, where the IMAGE study group estimated that a tenth of Europeans between the ages of 20-79 will have developed the disease by 2030, with much of the rise accounted for by people younger than 40. Diabetes now affects 55 million Europeans and accounts for an estimated 18% of Europe’s total healthcare costs, according to the IMAGE group, which comprised 92 investigators.

The inveThe investigators, led by Dr. Jaakko Tuomilehto of the Hjelt Institute in Helsinki and Dr. Peter Schwarz of the University of Dresden, cited robust, well-coordinated prevention efforts in some countries, particularly Finland and Germany, but said strategies are fragmented elsewhere.

The inveIn their evidence-based guideline, which cited 325 articles and studies, the investigators proposed a unified approach to defining at-risk people. It urged the wider use of risk scoring systems, such as the Finnish Diabetes Risk Score; mandatory counseling on diabetes for all patients at risk; and oral glucose tolerance testing for people with at least one serious risk factor.

The inveBesides assessing surgical and pharmaceutical interventions such as metformin and bariatric surgery for certain patients with exceptional risk, the team described a series of community-based interventions to promote lifestyle changes – predominantly weight loss and increased exercise – proven to reduce disease risk. They emphasized the role of local government, schools, and media in promoting these. “The responsibility for preventive efforts does not depend only on the healthcare system,” the investigators wrote.

The investigators acknowledged that their approach did not address specific requirements for ethnic and immigrant groups within Europe, or children. However, they said, the IMAGE guidelines apply to more than 80% of people with metabolic risk factors for diabetes in Europe.
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