Implementing Programs for the Primary Prevention of Diabetes in Non-Health-Care Settings: From Evidence to Practice

Extensive research demonstrates the effectiveness of two broad strategies to prevent or delay the onset of type 2 diabetes in adults: pharmacological therapy and structured lifestyle interventions. To date, however, high-quality preventive services have proved particularly challenging to deliver in health care settings, even when there is compelling evidence for their clinical cost-effectiveness. Conversely, resources and policies to support modest weight loss and moderate physical activity behaviors have a stronger capacity to reach vast segments of the population when offered in non-healthcare community settings. This chapter considers the current evidence base for cost-effective prevention of diabetes and explores implications and emerging research for implementing policies and programs to prevent type 2 diabetes in non-healthcare settings.