Population-Level Approaches to Preventing Type 2 Diabetes Globally

The strongest evidence for T2DM prevention comes from RCTs in which people at high risk for T2DM have participated in a structured lifestyle intervention that addresses nutrition, physical activity, weight loss, and stress reduction and coping skills, but a growing body of evidence suggests that population-level approaches implemented alongside approaches for those at high risk have the potential to reduce T2DM risk in the general population. Population-level approaches include modifications to the food environment (taxes and subsidies, changes to the food supply and availability, food and menu labeling, and mass media campaigns) and to the built environment (improving pedestrian or bicycle transportation systems and land use and environmental design interventions), as well as interventions that address underlying social and economic factors related to T2DM risk. Efforts to address population-level risk factors and implement change in communities across the globe utilizing the current knowledge base would be valuable, while research to build upon the evidence can help to further understand how to improve nutrition and physical activity at the population level. Rigorous natural experiments can play a role here, helping to fill knowledge gaps by providing science-based evaluations of the real-world effectiveness of major policies and their impact on disease outcomes, particularly in diverse populations, and to guide the prioritization and implementation of such approaches.

Automated summary

The strongest evidence for T2DM prevention comes from RCTs, but population-level approaches can reduce risks in the general population, including modifications to the food and built environment, as well as addressing social and economic factors. Efforts to implement change globally and rigorous natural experiments can help to further understand how to improve nutrition and physical activity at the population level.