Professor Jonathan Shaw, Associate Professor Anna Peeters, Dr Kathryn Backholer, and Associate Professor Dianna Magliano from the Baker IDI Heart and Diabetes Institute in Melbourne, Australia, examined three different strategy models to avert future diabetes cases that could be averted:
- The first strategy they examined was a 'junk food' tax as a population-wide prevention intervention. The scenario included an assumed body mass index decrease of about 0.5kg/m2.
- The second strategy focused on preventing diabetes in those with a high future risk, i.e. in people with high blood glucose levels. Measures involved intensive behavioral modification programs for those identified at high risk of future diabetes, i.e. those with high blood glucose levels. A typical behavioral modification program consisted of six counseling sessions targeted at reducing fat and saturated fat in the diet, increasing fiber, participating in at least four hours of moderate physical activity per week and losing more than 5% of weight over an 8 to12 months period.
- The third strategy involved morbidly obese individuals with newly diagnosed diabetes, who underwent surgery in form of an adjustable gastric band, which according to a recent randomized controlled trial, resulted in a 73% remission rate of type 2 diabetes.
An evaluation of the three strategies revealed that their second strategy - of high-risk prevention - proved to be the most effective by most likely averting 220,000 diabetes cases by 2025. This is a reduction of around 10%, bringing down the projected prevalence of diabetes from 11.4% to 10% of the population.
The first strategy of implementing a junk food tax was estimated to prevent around 38,000 cases, whilst gastric surgery would lead to a reduction of 65,000 diabetic cases in 2025. A combination of all three strategies would prevent approximately 253,000 cases.
"Given the costly complications associated with diabetes, reducing the burden of diabetes by even 10% is likely to have a profound influence on the health care system. The costs of managing diabetes are likely to increase over time as the population ages and people with diabetes are receiving better treatment and thus living longer."
Backholer explained that the research demonstrated that the best option is to focus on the high-risk prevention strategy and concluded:
"We need to focus preventive efforts towards intensive lifestyle intervention programs to ensure the best success of reducing the future burden of diabetes. We need to be prioritizing diabetes screening strategies to identify those at high risk of future diabetes and coming up with novel ways in which we can recruit and retain individuals into lifestyle prevention programs."
Written by Petra Rattue