A Consensus of Key Opinion Leaders on the Management of Pre-diabetes in the Asia-Pacific Region

Journal of the ASEAN Federation of Endocrine Societies, Vol 32, No 1 (2017) A Consensus of Key Opinion Leaders on the Management of Pre-diabetes in the Asia-Pacific Region Roberto Mirasol,* Ah Chuan Thai,** Aftab Ahmad,*** Kathryn CB Tan,**** Chaicharn Deerochanawong,***** Mafauzy Mohamed,? Made Saraswati,?? Bipin Kumar Sethi,??? Sanjiv Shah,???? Nanny Soetedjo,????? Swangjit Suraamornkul,? Rima Tan,?? Farid Uddin??? *St. Luke’s Medical Center, Philippines **Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore ***Jinnah Teaching Hospital, Pakistan ****Department of Medicine, University of Hong Kong, Hong Kong *****Rajavithi Hospital, Rangsit University, Thailand ?Universiti Sains Malaysia, Malaysia ??Division of Endocrinology and Metabolism, Sanglah General Hospital, Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia ???CARE Hospital, Hyderabad, India ????Nanavati Superspeciality Hospital, Mumbai, India ?????Division of Endocrinology and Metabolism, Hasan Sadikin General Hospital, Department of Internal Medicine, Faculty of Medicine, University of Pajajaran, Bandung, Indonesia ?Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand ??Institute for Studies on Diabetes Foundation, Inc., Philippines ???National Institute of Diabetes and Endocrinology, Dow University of Health Sciences, Pakistan Corresponding Author Roberto C. Mirasol, MD, FPCP, FPSEDM Chief, Section of Endocrinology, Diabetes and Metabolism St. Luke's Medical Center, Quezon City 279 E. Rodriguez Sr. Blvd., Quezon City 1102 E-mail: mirasolroberto@gmail.com e-ISSN 2308-118x Printed in the Philippines Copyright © 2017 by the JAFES Received May 15, 2016. Accepted January 25, 2017. Published Online First: May 5, 2017. ABSTRACT The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in this region. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance (IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment are urgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestyle modification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importance of lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting, experts from the Asian region convened to develop consensus recommendations to guide clinicians in the management of Asian patients with pre-diabetes. These consensus recommendations provide a clear and concise approach to the management of individuals with IGT based on the available evidence and current best clinical practice.