Diabetes prevention program

The Diabetes Prevention Program was a 3-year study that showed that lifestyle modifications, including exercise (30 minutes/day, 5 days/week) and moderate (5%-10%) weight loss, reduce the probability of developing DM by 58% in patients with pre-diabetes. Results from this study suggest that diet, exercise, and behavior modification are effective in preventing type 2 DM in high-risk patients.14... 

Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl 3 Med 2002 346 393. 

Diabetes Prevention Program Research Group Prevention of type 2 diabetes with troglitazone in the diabetes prevention program. Diabetes 2005 54 1150. 

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002 346(6) 393 103. 

The Diabetes Prevention Program Research Group. Effects of withdrawal from metformin on the development of diabetes in the Diabetes Prevention Program. Diabetes Care 2003 26 977-980. 

Diabetes Prevention Program Research Group (2002) Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin, N. Engl. J. Med. 346, 393-404. 

At each refill visit, the pharmacist reviewed the plan with the patient and provided reminders about the need for other preventive care, such as yearly eye exams and proper foot care. When appropriate, the physician was contacted, with the patient s consent, regarding specific treatment recommendations. In summary, this diabetes monitoring program showed the value of combining multiple interventions to improve adherence and outcomes. 

Edelson, E. (2011). Disease prevention programs Worth the investment. HealthDay. http //health. usnews.com/health-news/diet-fitness/diabetes/articles/2008/07/17/disease-pievention-programs-worth-the-investment... 

Rice bran fiber has fructo-oligosaccharides - a pre-biotic that helps friendly bacteria to proliferate in the gastrointestinal environment and improves intestinal and colon health (Tomlin and Read, 1988). Recent studies in humans (Kahlon and Chow, 1997) have revealed that rice bran fiber not only normalizes bowel function, but also helps in conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and Crohn s disease, and lowers the lipid levels. Rice bran fiber has been shown to significantly reduce renal stones (Jahnen et al., 1992). It is a good source of fiber in weight loss programs and therapeutic fiber diets for diabetics and heart patients. Fiber diets prevent cancer of the colon and large bowel, control obesity and improve bowel function. 

Post-MI management calls for strict adherence to a program of secondary prevention. Cardiac risk factors have to be excluded or modified, for instance, by reduction of overweight, cessation of smoking, optimal control of diabetes mellitus, and physical exercise (a dog that loves to run is an ideal training partner). Supportive pharmacother-apeutic measures include administration of platelet aggregation inhibitors, p-blockers, and ACE inhibitors. 

With a decreased need for pharmacists to identify obvious problems associated with pharmaceutical therapy, the pharmacist should be free to concentrate on patient-centered therapy issues. Pharmacists can spend more time with patients identifying barriers that might prevent a patient reaching an optimal outcome. Pharmacists can then address these issues with education and proactive adjustments in the patient s therapy. The pharmacist can concentrate more time on educating patients to better monitor their therapy to increase the likelihood of maximal therapeutic benefit without troublesome misadventures. Furthermore, the pharmacist could concentrate on therapeutic outreach programs such as brown bag clinics, diabetic care clinics, and asthma screening. 

As causal therapy is not available for many forms of foot complications, continuous care and patient education are mandatory. This is best developed for the prevention of the diabetic foot syndrome. In many countries, training programs as well as printed and electronic information are available. The key problem is that patients must compensate their diminished or lost sensory qualities by daily inspection of their feet for changes of color, blisters, fissures, or any other skin changes and also, daily inspection of shoes for foreign bodies is necessary. However, this might sometimes be problematic, particularly in patients who have additional eye problems or reduced mobility. 

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