型糖尿病的预防--第二届国际糖尿病前期会议精粹.ppt

拜唐苹降低2型糖尿病患者心血管事件风险 IDF:对高危人群的干预策略 FIN-D2D 项目, 目的 1.减少2型糖尿病发病率, 危险因素和用于2型糖尿病并发症的花费 2.识别2型糖尿病的高危人群 3.对于未知糖尿病的患者提供早期诊断 4.尽早让已知2型糖尿病的患者得到适当的治疗 5.制定适合当地情况的2型糖尿病预防模式和流程 6.证明预防的成本效益 芬兰2型糖尿病预防项目(2003-2010)的3个策略 一般人群策略 高危人群策略 早期诊治的策略 FIN-D2D:评估 按照专业的评估表对FIN-D2D 的可行性,效果以及花费进行评估 评估内容还包括比较FIN-D2D的5个区域和芬兰其它区域的2型糖尿病以及未诊断2型糖尿病的患病率和 IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert IDF 2006 Meet the Expert 1: Diabetologia. 2006 Feb;49(2):289-97. Epub 2006 Jan 4. ? Links The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Indian Diabetes Prevention Programme (IDPP). AIMS/HYPOTHESIS: Lifestyle modification helps in the primary prevention of diabetes in multiethnic American, Finnish and Chinese populations. In a prospective community-based study, we tested whether the progression to diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than the above populations. METHODS: We randomised 531 (421 men 110 women) subjects with IGT (mean age 45.9+/-5.7 years, BMI 25.8+/-3.5 kg/m(2)) into four groups. Group 1 was the control, Group 2 was given advice on lifestyle modification (LSM), Group 3 was treated with metformin (MET) and Group 4 was given LSM plus MET. The primary outcome measure was type 2 diabetes as diagnosed using World Health Organization criteria. RESULTS: The median follow-up period was 30 months, and the 3-year cumulative incidences of diabetes were 55.0%, 39.3%, 40.5% and 39.5% in Groups 1-4, respectively. The relative risk reduction was 28.5% with LSM (95% CI 20.5-37.3, p=0.018), 26.4% with MET (95% CI 19.1-35.1, p=0.029) and 28.2% with LSM + MET (95% CI 20.3-37.0, p=0.022), as compared with the control group. The number needed to treat to pre