Prevention of Blindness and Visual Impairment

Prevention of diabetes mellitus

Report of a WHO study group

ISBN: 92 4 120844 9

Reviews current and potential opportunities for the prevention of diabetes mellitus and the improvement of prognosis through the early detection and treatment of complications. Drawing on striking recent progress in knowledge about the disease, the report aims to identify specific preventive interventions, at primary, secondary, and tertiary levels, that have been shown to be feasible, effective, ethical, and thus most likely to represent a wise investment of resources.

Opportunities for primary prevention are considered in separate sections devoted to insulin-dependent and non-insulin-dependent forms of the disease. Secondary prevention is covered in the next section, which discusses the factors to be considered when planning screening programmes to detect asymptomatic individuals who have the disease or are at high risk of developing it. Guidance on the appropriate use of screening programmes is given for three approaches: population, selective, and opportunistic.

The most extensive section, on tertiary prevention, provides a detailed guide to the many actions that can help to prevent or delay the development of complications and thus improve prognosis considerably. Each of the main acute and chronic complications of diabetes is discussed in terms of predisposing factors, early warning signs, methods of diagnosis, interpretation of findings, and appropriate preventive interventions. Since many of these disorders are asymptomatic in their early stages, the report gives particular attention to the need for better education of patients and physicians.