Type 2 diabetes prevention. Experts' Group position paper endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy

Abstract

Type 2 diabetes is responsible for approximately 90% of all diabetes worldwide and it is a global public health problem. This is a chronic, progressive, metabolic disease characterised by hyperglycaemia, which leads to microangiopathic and macroangiopathic complications. Subjects with type 2 diabetes have increased mortality and a reduced life expectancy compared with those without diabetes. Strong evidence supports the fact that identification of type 2 diabetes risk factors and early intervention influencing the modifiable ones can reduce incidence rate of diabetes and prevalence of its complications. There are many advantages of such interventions for patients (prolonged life expectancy, improvement of life quality) and for the whole society (reduction of the costs). Therefore the guidelines for the prevention of type 2 diabetes are needed. Experts of the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy reviewed recently published clinical studies regarding the prevention of type 2 diabetes and prepared their recommendations. The guidelines are designed to assist clinicians and other healthcare workers to make evidence based management decisions. The strategies are grouped broadly into interventions that aim to change lifestyle through physical activity and diet, interventions based on drug administration (pharmacotherapy) and surgical interventions.

Classification, Symptoms, Treatment and Preventive Strategies of Diabetes. A guide to the basic

“…Consuming alcohol in moderation can have a positive impact on health. Moderate intake of red wine is recommended due to its antioxidant properties, which may help reduce the risk of cardiovascular diseases [37].…”

Obesity in Adults: Position Statement of Polish Association for the Study on Obesity, Polish Association of Endocrinology, Polish Association of Cardiodiabetology, Polish Psychiatric Association, Section of Metabolic and Bariatric Surgery of the Association of Polish Surgeons, and the College of Family Physicians in Poland

“…In isolated IGT, on the other hand, muscle insulin resistance and a defect in the second phase of insulin secretion result in long-term hyperglycemia. In addition, the post-prandial release of glucagon-like peptide-1 is impaired, resulting in decreased insulin secretion [ 42 ].…”

“…Prediabetes is an early stage in the development of type 2 diabetes. The progression of carbohydrate metabolism disorders towards diabetes is associated with impaired compensatory insulin secretion due to increased apoptosis of pancreatic islet β cells, which is facilitated by both impaired GLP-1 secretion and increased release of pro-inflammatory cytokines and leptin by visceral adipose tissue, as well as increased glucagon secretion and increased hepatic glucose synthesis as well as progressive changes in skeletal muscle metabolism [ 42 ].…”

Diabetes - diagnosis, treatment, complications and rehabilitation

“…A decrease in BMI, weight loss, pressure control, reduction of blood glucose are just some of the advantages of physical activity. According to WHO recommendations, moderate physical effort 30 minutes 5 times a week or high-intensity endurance training 3 times a week for 20 minutes is recommended for maintaining health and preventing chronic diseases [23]. The Da Qing IGT and Diabetes Study, this study aimed to assess how lifestyle changes would affect the prevention of type 2 diabetes.…”