Thread by @GDiabetesJC

1/We are diving into the recently published @TheLancet diabetes commission report.

Today’s thread: Prevention of type 2 diabetes in populations and individuals at high risk

Let’s start with the end: the recommendations from the commission.. (part 1 of 3)

2/The aetiology of T2D is multidimensional and hence prevention must be multidimensional; meaning that prevention efforts should operate within levels of the:

Individual
Community
Society

A framework for this was proposed (fig below).

3/On the individual level, the practice environment could be redesigned to a team-based care approach operating from community-based diabetes teams and centres.

4/The diabetes teams workflow would include: “gather data systematically, stratify risk, personalise care, provide feedback and perform periodic monitoring”

The teams are working at the forefront: identifying high risk individuals and directing relevant interventions.

5/But the individual level actions cannot stand alone.

On the community level, policies need to enforce the environment necessary to succeed and enable healthy communities.

6/For instance, policies on tobacco and sugar sweetened beverages. Universal health coverage is also an important component for a healthy community.

7/On the society level, policies must aim to reduce social disparity and ensure basic education for all individuals while also meeting the sustainable development goals.

All these levels tie into each other.

The more aligned, the greater the effect on prevention will be.

8/Okay, but what was the foundation for this recommendation? What do we know about prevention?

Where are the risk factors, which interventions work, are they cost-effective, who should be acted upon and how?

Many important questions to dive into.. In part 2 on prevention..