1/We’re back with the 3rd and final part of our mini-#threadseries on diabetes prevention
The last part is about balancing individual and population level prevention. As well as how to make evidence-based decisions on some of these population level interventions.
The last part is about balancing individual and population level prevention. As well as how to make evidence-based decisions on some of these population level interventions.
2/Individual level prevention targeted behaviors like diet and exercise. These should also be the target of population level interventions. Although these behaviors are within the control of the individual. They are also impacted by society-level factors.
3/ For instance, it is hard to eat healthy food if it is expensive or not available. It is also hard to reduce exposure to air pollution if there is a lot in the city you live in..
4/The community and society level interventions are the foundation of diabetes prevention. As with individual level prevention, large trials would be ideal to base decision on implementation on (see process 👇). There is just one problem… 
5/Many of such interventions cannot be randomized (or are ethical or timely). What do we do then?
6/Well, the commission has a suggestion. To build public health interventions based on the best available observational (and interventions, if available) evidence, consider how to evaluate this the best way, like using natural experiments, implement the policy and evaluate
7/The full model looks like this 👇👇. More details on this in the paper by Ogilvie et al. (great read btw) jech.bmj.com/content/74/2/2…
8/An example could be the introduction of sugar-sweetened beverage taxes (levy) in the UK that are currently being evaluated.
Another example is prohibition of smoking in public places in Scotland in 2006. A 17%⬇️ in admissions due to coronary syndrome was seen a year after.
Another example is prohibition of smoking in public places in Scotland in 2006. A 17%⬇️ in admissions due to coronary syndrome was seen a year after.
9/This way of “turning the evidence-based medicine paradigm on its head” (name of the Ogilvie et al-paper) requires bold actions from politicians to implement more nationwide public health interventions.
10/The upshot is that public health interventions may have a big health impact on the population, although the individual level benefit may not seem that big.
11/And as we have seen with the #COVID19 pandemic, bold solutions through collective efforts is what end (dramatically reduces) epidemics.
With the projected global rise in the number of people with T2D in future years, prevention is more important than ever.
The end.
With the projected global rise in the number of people with T2D in future years, prevention is more important than ever.
The end.
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