Royal College of Surgeons in Ireland
Type 2 Diabetes Prevention Programs-From Proof-of-Concept Trials to National Intervention and Beyond.pdf (612.97 kB)

Type 2 diabetes prevention programs - from proof-of-concept trials to national intervention and beyond

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journal contribution
posted on 2023-03-29, 10:34 authored by Jaakko Tuomilehto, Matti Uusitupa, Edward GreggEdward Gregg, Jaana Lindström

The prevention of type 2 diabetes (T2D) in high-risk people with lifestyle interventions has been demonstrated by several randomized controlled trials. The intervention effect has sustained up to 20 years in post-trial monitoring of T2D incidence. In 2000, Finland launched the national T2D prevention plan. For screening for high T2D risk, the non-laboratory Finnish Diabetes Risk Score was developed and widely used, also in other countries. The incidence of drug-treated T2D has decreased steadily since 2010. The US congress authorized public funding for a national diabetes prevention program (NDPP) in 2010. It was built around a 16-visit program that relies on referral from primary care and self-referral of persons with either prediabetes or by a diabetes risk test. The program uses a train-the-trainer program. In 2015 the program started the inclusion of online programs. There has been limited implementation of nationwide T2D prevention programs in other countries. Despite the convincing results from RCTs in China and India, no translation to the national level was introduced there. T2D prevention efforts in low-and middle-income countries are still limited, but results have been promising. Barriers to efficient interventions are greater in these countries than in high-income countries, where many barriers also exist. Health disparities by socioeconomic status exist for T2D and its risk factors and form a challenge for preventive interventions. It seems that a stronger commitment to T2D prevention is needed, such as the successful WHO Framework Convention on Tobacco Control, which legally binds the countries to act. 


Science Foundation Ireland (grant number 22/RP/10091)

Academy of Finland (grant number 332466)



The original article is available at

Published Citation

Tuomilehto J, Uusitupa M, Gregg EW, Lindström J. Type 2 diabetes prevention programs - from proof-of-concept trials to national intervention and beyond. J Clin Med. 2023;12(5):1876

Publication Date

27 February 2023

PubMed ID



  • School of Population Health




  • Published Version (Version of Record)