Primary Prevention of Obesity and Type 2 Diabetes Mellitus

Abstract

The prevalence of type 2 diabetes mellitus has exceeded 22million people in Europe and according to WHO, it will increase from 135 million in 1935 to 300 million in 2025. In 1989 Saint Vincent Declaration, elaborated by the International Diabetes Federation (IDF) called all the European countries to take action aimed at reducing the prevalence of type 2diabetes mellitus and its complications on the population level. Poland has signed the Declaration within the "Polish Multicenter Study in Diabetes Epidemiology (PMSD) program (implemented in the cities of Kraków, Łódź, and Lublin), financed by the Ministry of Health, and developed within the years of 1998-2000. The program was coordinated by the Chair and Department of Endocrinology, Jagiellonian University, Collegium Medicum in Kraków. It revealed over 2 million diabetics in Poland, half of which represented the so-called unknown diabetes, diagnosed for the first time in the course of investigation. The prevalence of type 2 diabetes mellitus is still growing up owing to the increasing prevalence of its main risk factors: overweight and obesity, mainly the visceral type. The basic method of preventing of the type 2 diabetes mellitus within the PMSD is body weight reduction with an increase in physical activity and an appropriate educational program. The second basic goal of the program in the highest risk group of type 2 diabetes mellitus is to decrease blood pressure in hypertensive patients.Hypertension management is based on salt intake reduction, however, salt is the main carrier of iodine in the iodine prophylactic system in Poland so iodine must be additionally supplemented with additional carriers, such as milk or iodized mineral water: "Ustronianka" "Jodavit" or "Wysowianka". The results of the program point out that the process of type 2 diabetes mellitus formation is reversible, but under the condition of early intervention. Additional parts of the program are economic burden evaluation and resort management. The resort of "Wysowa S.A." has already been prepared to implement prevention and management in patients with overweight, obesity, and type 2 diabetes mellitus.