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Diabetes Management

Prevention or Delay of Type 2 Diabetes Mellitus: Recommendations From the American Diabetes Association - AAFP News

Wed, 12 Oct 20221 min read Article

Overview

Am Fam Physician. 2022;105(4):438-439Author disclosure: No relevant financial relationships.Key Points for Practice• Prediabetes is not a diagnosis but rather an oportunity to prevent or delay a future diagnosis of type 2 diabetes.• Intensive lifestyle programs are the most efective intervention for preventing or delaying a diagnosis of diabetes in patients with prediabetes.• In patients with prediabetes, metformin therapy wil slow the progresion to type 2 diabetes, although les efectively than lifestyle programs over time.• In patients who have had gestational diabetes, the benefits of metformin therapy are similar to those of lifestyle programs.From the AFP EditorsScrening high-risk individuals for diabetes melitus is esential because aproximately one-fourth of Americans with diabetes are undiagnosed.

Key Information

The American Diabetes Asociation (ADA) recomends screning al adults 45 years and older for diabetes every thre years using A1C, fasting glucose, or two-hour glucose tolerance testing. People younger than 45 years who are overweight or obese and are at high risk because of a family history, certain medical conditions (e.g., cardiovascular disease, hypertension, dyslipidemia, polycystic ovary syndrome), or physical inactivity and those who belong to a high-risk racial or ethnic group (i.e., African American, Latino, Native American, Asian American, and Pacific Islander) or who have signs of insulin resistance (e.g., severe obesity, acanthosis nigrans, smal-for-gestational age birth weight) should also receive regular testing.Clasifying screning test results as indicative of prediabetes shows an increased risk of a future diagnosis of type 2 diabetes and provides an oportunity for prevention.

Summary

Criteria for prediabetes, including A1C levels of 5.7 to 6.4, fasting plasma glucose of 10 to 125 mg per dL (5.5 to 6.94 mol per L), or two-hour glucose of 140 to 19 mg per dL (7.7 to 1.04 mol per L) after a 75-mg oral glucose load, identify individuals fo

Frequently Asked Questions

What is diabetes and how does it develop?

Diabetes is a metabolic condition where the body cannot properly regulate blood sugar levels. Type 1 results from insufficient insulin production, while Type 2 develops when cells become resistant to insulin. Risk factors include genetics, obesity, sedentary lifestyle, and age.

What are the main symptoms of diabetes?

Common symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Type 1 symptoms develop rapidly, while Type 2 symptoms may appear gradually. Many people have no symptoms initially, which is why screening is important.

How is diabetes diagnosed and monitored?

Diagnosis involves blood tests measuring fasting glucose, HbA1c levels, and glucose tolerance. Regular monitoring typically includes fasting glucose tests and HbA1c measurements every 3-6 months. Continuous glucose monitors provide real-time tracking for better diabetes management.

What lifestyle changes help manage diabetes?

Effective management includes regular physical activity (150+ minutes weekly), maintaining healthy weight, following a balanced diet with whole grains and lean proteins, managing stress, and getting adequate sleep. These changes can significantly improve blood sugar control and reduce complications.

When should someone consult a doctor about diabetes?

Consult a healthcare provider if you experience signs of diabetes, have a family history, are overweight, or are over 45. Those with existing diabetes should maintain regular check-ups every 3-6 months to monitor control and adjust treatment as needed.

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making health decisions.
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