Several countries have developed and implemented diabetes prevention programmes, including China, India, Japan, Finland, and the US . Out of these models, “The Diabetes Prevention Program of US” and “The Finnish Diabetes Prevention Study” have demonstrated significant outcomes. These two models are found to have reduced T2Dby up to 58 percent in patients over 16s having pre-diabetes. This is achieved through weight loss resulting from lifestyle changes. Regardless of the development of these models, there has been a constant increase in the prevalence of T2D in people over 16s due to lack of adoption of these models. The mortality rate due to diabetes has decreased, but the diabetes-related complications have continued to grow.
Recent studies based on these models have found encouraging results across different research settings, which includes cardiac rehabilitation programmes, primary care settings healthcare facilities, churches, and YMCAs. These interventions were implemented by various personnel, including YMCA trainers, nurses, healthcare professionals, registered exercise physiologists and dieticians, and volunteer medical personnel. The subsections below briefly discuss the Finnish and US DPP models.
This programme was the first large-scale national DPP in the world, known as the “National Program for the Prevention of Type 2 Diabetes (FIN-D2D)”. The DPP was implemented in five hospital districts during 2003 to 2008 in Finland, thus affecting 1.5 million people. The model included the following concurrent strategies: population strategy, early treatment strategy, and high-risk strategy. The populace approach focuses on increasing awareness of diabetes and risks associated with the disease. On the other hand, the early treatment strategy focuses on treatment of individuals having screening-detected diabetes. Lastly, the high-risk strategy aims at “prevention of diabetes and reduction of cardiovascular risk factor levels among high-risk individuals”.
The DPP developed by the US was a groundbreaking RCT which significantly reduced the incidence of diabetes by adopting a structured lifestyle intervention by the patients. In addition, the model helped high-risk individuals to significantly reduce diabetes with prophylactic metformin. As a result, this study, as well as other similar studies, introduced diabetes prevention techniques based on structured lifestyle programs and metformin to clinical practice ADA now primarily recommends metformin and intensive lifestyle interventions as methods to prevent diabetes in adults and high-risk patients.