Prevention of type 2 diabetes in Germany. Ideas - Evidence - Implementation

One of the challenges in clinical diabetology today is to develop and implement diabetes prevention management programs for clinical practice. Recent studies have convincingly demonstrated that lifestyle intervention, addressing diet and exercise, as well as pharmacological preventive strategies reduce the risk of progressing from impaired glucose tolerance to diabetes. With respect to the worldwide burden of diabetes, these studies offer a compelling evidence base for the important translation of the research findings into community-based prevention strategies and the development of a national diabetes prevention program. The work group diabetes prevention of the German Diabetes Association together with the National Action Forum Diabetes and the German Diabetes Foundation developed a concept for a national program. This comprises a three-step intervention: in a first step individuals at high risk of developing type 2 diabetes are identified. The second step provides an intensive group intervention to prevent diabetes, and in a third step continuous intervention should facilitate motivation maintenance and evaluation. This third step is the crucial step to maintain the effect in changing lifestyle. Recently, a compendium for diabetes prevention was developed as a practical guideline explaining how to implement prevention programs. This guideline also includes the structure of a national prevention program with a prevention manager having a central role in the concept and suggestions for evaluation and quality control.