Prevention and management strategies are crucial to turn back the tide regarding obesity and diabetes. Evidence demonstrates that risks of chronic disease begin in the uterus and continue into old age. Therefore, strategies to address the problem at all stages of the life cycle are important, including paying particular attention to obesity and diabetes in women of reproductive age.
The frequency of medical care and health expenditures among those with diabetes increases as early as eight years before clinical onset of the disease. This means that persons at the highest risk for type 2 diabetes are often already in contact with the health system and can be easily identified. People with prediabetes have been shown to have increased risk for diabetes and cardiovascular diseases. Diabetes screening facilities are the opportune identification point for such at-risk individuals, or for those in the early stages of obesity and diabetes, when non-pharmacological treatment may still be a preferred option. Studies have demonstrated that approximately one-third of people with type 2 diabetes are undiagnosed, and already present complications at the time of diagnosis.
Two approaches need to be used to implement prevention strategies: the population-based approach and the individual, high-risk approach. The individual approach focuses on high-risk or affected individuals through direct interventions.
The population and individual approaches are complementary and function best when combined in an integrated manner.