A recent consensus statement, titled Call to Action for Clinicians in the South-East Asian Regions on Primary Prevention of Diabetes in People with Prediabetes, has outlined a crucial set of clinical guidelines designed to address the rising prevalence of type 2 diabetes in India and Southeast Asia. Published in Diabetes Research and Clinical Practice, the statement emphasizes the importance of primary prevention programs and highlights a three-step process for clinicians to identify, diagnose, and intervene with individuals at high risk of developing the disease. This approach includes screening to identify high-risk individuals, diagnosing prediabetes or intermediate hyperglycaemia, and delivering personalized intervention strategies that combine diet, physical activity, and medication.
Understanding the Rising Risk of Diabetes
In the face of growing concerns over the increasing number of diabetes cases, experts have underscored the need for targeted prevention efforts. Diabetes is not just an emerging health crisis in India, but also across the South-East Asian region, where populations face unique genetic and environmental risks. Dr. A. Ramachandran and Dr. Nanditha, primary authors from Dr. Ramachandran’s Diabetes Hospital and the India Diabetes Research Foundation in Chennai, noted that South Asian populations, particularly Indian ethnic groups, are genetically predisposed to develop diabetes even with relatively low levels of obesity and fewer traditional risk factors.
The Role of Lifestyle Changes and Medications
In the Daily News Highlights, the significance of these guidelines has been emphasized as a simplified yet highly effective approach to managing the diabetes epidemic. According to the expert group, diabetes can be delayed or even prevented through early intervention involving lifestyle changes, including weight management through diet and exercise, and pharmacological interventions such as metformin. The consensus statement posits that such measures can be highly cost-effective in preventing the onset of diabetes, providing hope to both clinicians and individuals in high-risk regions.
The Three-Step Plan for Prevention
The guidelines advocate for a structured, three-step plan. First, clinicians should conduct screening using non-invasive risk score assessments to identify individuals at risk before proceeding with blood tests. This method is especially efficient in terms of time and cost. Validated risk scores have been developed for various ethnic groups, including Asian Indians, and take into account factors such as a history of prediabetes, gestational diabetes, polycystic ovarian syndrome (PCOS), hypertension, and low birth weight, all of which increase the likelihood of developing diabetes.
Diagnosis of Prediabetes and Intermediate Hyperglycaemia
The second step is diagnosing prediabetes or intermediate hyperglycaemia. The criteria for this diagnosis are specific and include fasting plasma glucose levels between 110 and 125 mg/dL or HbA1c levels between 6.1% and 6.4%. Once diagnosed, individuals can receive targeted interventions to manage their condition, helping to prevent the progression to full-blown type 2 diabetes.
Devising Personalized Strategies for Prevention
Finally, the third step involves creating a personalized strategy for primary prevention, focusing on a combination of diet, physical activity, and medication. A balanced and nutrient-rich meal plan for weight management is recommended, alongside moderate-intensity physical activity and strength training exercises. For those who cannot achieve weight loss or manage their blood sugar levels through lifestyle modifications alone, medication may be introduced as part of the prevention strategy.
Raising Awareness Among Clinicians
The next crucial step involves increasing awareness among clinicians, particularly primary care physicians and family practitioners, about the importance of primary prevention in managing diabetes. Although these healthcare providers are familiar with preventive measures for infectious diseases such as vaccination programs, many are less aware of the need for preventative strategies for chronic conditions like diabetes. By improving education and raising awareness of the significance of early intervention, healthcare providers can play a pivotal role in reducing the incidence of type 2 diabetes.
The Key Role of Primary Care Physicians
Health experts argue that primary care physicians are in a unique position to implement these prevention programs effectively. They have direct access to high-risk populations, including family members of individuals already diagnosed with diabetes. These professionals can identify at-risk individuals early and implement preventive strategies, thus reducing the overall burden of the disease.
Global Insights on Diabetes Prevention
The Global News highlights that several experts in diabetes research believe that the primary prevention of diabetes is one of the most effective ways to combat the growing epidemic. Evidence from randomized control trials supports the idea that lifestyle changes, including diet and exercise, can prevent or delay the onset of type 2 diabetes. In addition, targeted medications like metformin have shown promising results in reducing the risk of progression from prediabetes to full-blown diabetes.
A Feasible Path Forward for Diabetes Prevention
In conclusion, the expert consensus on primary prevention of type 2 diabetes offers a vital pathway for addressing the diabetes epidemic in India and Southeast Asia. By focusing on early identification through screening, diagnosing prediabetes, and delivering personalized intervention plans, healthcare providers can take proactive steps to combat the disease. The involvement of primary care physicians is especially crucial in ensuring that these guidelines are effectively implemented in both urban and rural areas. The global community of healthcare professionals and researchers agrees that raising awareness and implementing these primary prevention strategies can significantly reduce the burden of type 2 diabetes, improving public health outcomes across the region.
