Trends in diabetes: sounding the alarm

Overweight and obesity, together with physical inactivity, are responsible for a substantial proportion of the global diabetes burden.5 Changes at population level to improve access to healthy foods and beverages, and to opportunities for physical activity, facilitate positive behaviour change and are likely to have an impact on the occurrence of type 2 diabetes.6 The intermediate approach proposed by the authors--supportive intervention to promote changes in diet and physical activity among people at high risk of type 2 diabetes, possibly accompanied by the use of medications--is backed by strong evidence of effectiveness.7-11 The ultimate advisability of targeted interventions for people at high risk depends heavily on local context, such as availability of sufficient human and financial resources, as well as essential equipment and technology, to manage the approach at the primary-care level.