Implementation Conference for ACE Outpatient Diabetes Mellitus Consensus Conference Recommendations:
Position Statement

Over 20 million Americans suffer from diabetes; approximately one third of individuals with diabetes are undiagnosed. An additional 41 million have pre-diabetes (impaired glucose tolerance and/or impaired fasting glucose), a condition that often leads to diabetes if left untreated. On January 31, 2005, the American College of Endocrinology (ACE) and American Association of Clinical Endocrinologists (AACE) convened a two-day consensus conference to review current research and address questions relevant to the treatment of diabetes.

Question 1: Are we intervening early enough to address glycemic control and insulin resistance in glucose intolerant states?

No. Numerous studies have shown that significant cardiovascular disease develops years before the onset of diabetes. Hyperglycemia has been shown in epidemiologic studies to have a strong association with cardiovascular disease. In the absence of an intervention, impaired glucose tolerance (IGT), characterized by postprandial hyperglycemia, often progresses to type 2 diabetes. There are sufficient data to recommend intervention to prevent progression of IGT to type 2 diabetes. Large randomized controlled studies have shown the effectiveness of lifestyle interventions in preventing the progression of IGT to type 2 diabetes; a 58% reduction was demonstrated in both the Diabetes Prevention Program and Diabetes Intervention Study.

The above reference is a condensed version of an article published on the AACE web site at http://www.aace.com/pub/odimplementation/index.php. For a pdf of this article, click here or on the title above.