Preventing Diabetes in American Indian Communities

Diabetes Care July 1, 2013

Diabetes incidence can be reduced by lifestyle interventions aimed at weight loss, diet change, and increased physical activity, according to several randomized clinical trials (RCTs) (1–5). Similarly, diabetes incidence rates were reduced in RCTs of metformin, acarbose, troglitazone, rosiglitazone, and pioglitazone (1,4,6–9). These RCTs enrolled nondiabetic adults who were at high risk of developing type 2 diabetes by virtue of having one of more of these characteristics: overweight or obesity, elevated fasting glucose, and impaired glucose tolerance in an oral glucose tolerance test. These lifestyle or drug interventions reduced diabetes incidence rates substantially, with risk reductions ranging from about 25–75%. Diabetes incidence was reduced by 58% during the 2.8-year initial phase of the largest such lifestyle intervention trial, the U.S. Diabetes Prevention Program (DPP) (1). This occurred among all the major race/ethnic groups in the DPP, including American Indians.  Read more