Prevention of diabetes: a strategic approach for individual patients

Summary The ‘diabetes epidemic’ is an important health and socioeconomic problem worldwide. Type 2 diabetes is a chronic disease with gradual deterioration in glucose metabolism which causes multiple systemic complications. Therefore, early intervention in the prediabetic stage is a valuable approach to reduce diabetes development and related complications. Many clinical trials have suggested that lifestyle intervention, including moderate‐intensity exercise and diet control, and pharmacologic intervention using metformin, α‐glucosidase inhibitors, thiazolidinediones, anti‐obesity drugs and incretin mimics, are effective in preventing diabetes development. However, an individualized approach with careful consideration of the patient’s risk status and health economics is needed to perform a successful intervention programmes. In this review, we will summarize the known evidence on treatment‐ and cost‐effectiveness of drug and lifestyle treatment. Additionally, we will propose a strategic approach algorithm that is applicable to clinical practice.