Abstract：
OBJECTIVE:Translating lessons from clinical trials on the prevention or delay of type 2 diabetes to populations in nonstudy settings remains a challenge. The purpose of this paper is to review, from the perspective of practicing clinicians, available evidence on lifestyle interventions or medication to prevent or delay the onset of type 2 diabetes. DESIGN:A MEDLINE search identified 4 major diabetes prevention trials using lifestyle changes and 3 using prophylactic medications. We reviewed the study design, key components, and outcomes for each study, focusing on aspects of the interventions potentially adaptable to clinical settings. RESULTS:The lifestyle intervention studies set modest goals for weight loss and physical activity. Individualized counseling helped participants work toward their own goals; behavioral contracting and self-monitoring were key features, and family and social context were emphasized. Study staff made vigorous follow-up efforts for subjects having less success. Actual weight loss by participants was modest; yet, the reduction in diabetes incidence was quite significant. Prophylactic medication also reduced diabetes risk; however, lifestyle changes were more effective and are recommended as first-line strategy. Cost-effectiveness analyses have shown both lifestyle and medication interventions to be beneficial, especially as they might be implemented in practice. CONCLUSION:Strong evidence exists for the prevention or delay of type 2 diabetes through lifestyle changes. Components of these programs may be adaptable for use in clinical settings. This evidence supports broader implementation and increased reimbursement for provider services related to nutrition and physical activity to forestall morbidity from type 2 diabetes.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Burnet DL,Elliott LD,Quinn MT,Plaut AJ,Schwartz MA,Chin MHdoi
10.1111/j.1525-1497.2005.0277.xsubject
Has Abstractpub_date
2006-01-01 00:00:00pages
84-93issue
1eissn
0884-8734issn
1525-1497pii
JGI277journal_volume
21pub_type
杂志文章,评审abstract：BACKGROUND:Genomics will play an increasingly prominent role in clinical medicine. OBJECTIVE:To describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results. DESIGN:Qualitative analysis. PARTICIPANTS:PCPs and their generally healthy patients undergoing genome ...
journal_title：Journal of general internal medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s11606-017-4295-4
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:National guidelines make recommendations regarding the initial opioid prescriptions, but most of the supporting evidence is from the initial episode of care, not the first prescription. OBJECTIVE:To examine associations between features of the first opioid prescription and high-risk opioid use in the 18 mon...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-018-4628-y
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Patients frequently experience suboptimal transitions from the hospital to the community, which can increase the likelihood of readmission. It is not known which care coordination services can lead to improvements in readmission rates. OBJECTIVE:To evaluate the effects of two care coordination interventions...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-017-4218-4
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Questions persist about how learning healthcare systems should integrate audit and feedback (A&F) into quality improvement (QI) projects to support clinical teams' use of performance data to improve care quality. OBJECTIVE:To identify how a virtual "Hub" dashboard that provided performance data for patients...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06160-y
更新日期：2020-11-01 00:00:00
abstract：:General Internal Medicine research evolves in response to the needs of the patients to whom we provide care. Currently, many studies exclude older adults who deeply affect the clinical care of this population. With the number of older adults increasing, creating research protocols that include older adults with multip...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-013-2719-3
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:Little is known regarding the prevalence or risk factors for non-comprehension and non-compliance with discharge instructions among older adults. OBJECTIVE:To quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. RESE...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-014-2956-0
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Medical student interest in internal medicine is decreasing. Whether the internal medicine sub-internship affects intent to pursue internal medicine is unknown. OBJECTIVE:Determine the immediate and longer-term effect of the medicine sub-internship on students' decision to pursue internal medicine residency...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1263-7
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:High-quality communication about end-of-life care results in greater patient and family satisfaction. End-of-life discussions should occur early during the patient's disease trajectory and yet is often addressed only when patients become severely ill. As a result, end-of-life discussions are commonly initiat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05615-1
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE:To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfac...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-017-3997-y
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Stigma is associated with depression treatment, however, whether stigma differs between depression treatment modalities is not known, nor have racial differences in depression treatment stigma been fully explored. OBJECTIVE:To measure stigma for four depression treatments and estimate its association with t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0276-3
更新日期：2007-09-01 00:00:00
abstract：:To investigate the frequency of physician delivery of advice to stop smoking and patient characteristics affecting whether physicians deliver such advice, the authors surveyed 97 current cigarette smokers seen in two specialty and one general medicine clinic at a university medical center. Approximately two thirds of ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596170
更新日期：1987-09-01 00:00:00
abstract：OBJECTIVES:1) To describe the prevalence of eight injury-prone behaviors (IPBs) and the associations of these behaviors with ten standard chronic disease and sociodemographic risk factors (CDSRFs) among internal medicine patients and 2) to identify a subset of patients with multiple IPBs who might be at particularly hi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599194
更新日期：1992-11-01 00:00:00
abstract：BACKGROUND:Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain. OBJECTIVE:To assess the effect of student satisfaction with the inpatient general medicine rotation on pursuit of a career in GIM. DESIGN:Multicente...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1525-1497.2006.00429.x
更新日期：2006-05-01 00:00:00
abstract：:The authors conducted an observational study of attending rounds to determine the current status of this form of clinical teaching in a university-based internal medicine department. Using two forms of measurement, questionnaires and timed observations, we found that 63% of attending physician time was spent in the co...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599208
更新日期：1992-11-01 00:00:00
abstract：BACKGROUND:Few data have evaluated the relationship between caregiving and cardiovascular disease (CVD) risk. OBJECTIVE:The purpose of this study was to determine the prevalence and predictors of caregiver strain and to evaluate the association between caregiving and CVD lifestyle and psychosocial risk factors among f...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-008-0852-1
更新日期：2009-01-01 00:00:00
abstract：OBJECTIVE:Routine screening for prostate cancer is controversial because of frequent false-positive results, the potential for slow, non-life-threatening growth of untreated cancer, the uncertainty regarding whether treatment can extend life, and the potential for treatment complications. This study examines how inform...
journal_title：Journal of general internal medicine
pub_type： 临床试验,杂志文章
doi：10.1007/BF02600045
更新日期：1996-06-01 00:00:00
abstract：BACKGROUND:Many primary care physicians (PCPs) are ill-equipped to provide screening and counseling for inherited breast cancer. OBJECTIVE:To evaluate the outcomes of an interactive web-based genetics curriculum versus text curriculum for primary care physicians. DESIGN:Randomized two-group design. PARTICIPANTS:121 ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-014-3113-5
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Although hip fractures in older adults are associated with a high degree of mortality and disability, the use of advance care planning (ACP) in this population is unknown. OBJECTIVE:To determine the prevalence of ACP and need for surrogate decision-making prior to death in older adults with hip fracture and...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05644-1
更新日期：2020-07-01 00:00:00
abstract：SPECIFIC AIM:Although the Department of Veterans Affairs (VA) has made significant organizational changes to improve diabetes care, diabetes self-management has received limited attention. The purpose of this study is to assess factors influencing diabetes self-management among veterans with poorly controlled diabetes....
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-006-0053-8
更新日期：2007-04-01 00:00:00
abstract：:LM Montgomery's The Blue Castle was first published in 1926, yet contains many insights into medical practice that remain relevant today. The protagonist, Valancy, mistakenly receives a terminal diagnosis in a letter from her physician, who has sent her a note intended for another patient. Her interactions with the ph...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1394-x
更新日期：2010-10-01 00:00:00
abstract：BACKGROUND:The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area. OBJECTIVE:This observational multi-si...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-019-05070-y
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. OBJECTIVE:To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management a...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3686-2
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Despite significant investment in colorectal cancer (CRC) screening, 40% of US adults are not up-to-date. Commitment devices, which are psychologically tailored approaches to enforce health goals, may be an effective method to increase CRC screening. OBJECTIVE:Compare the effectiveness of a commitment devic...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06392-y
更新日期：2021-01-20 00:00:00
abstract：OBJECTIVES:To describe and explain the patterns of adherence to supplemental oxygen in individuals with hypoxemic chronic obstructive pulmonary disease (COPD). DESIGN:Qualitative study of a case-series of patients with COPD who use supplemental oxygen. SETTING:Denver, Colorado. PARTICIPANTS:Community-dwelling, Engli...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.20218.x
更新日期：2002-10-01 00:00:00
abstract：BACKGROUND:Seasonal influenza vaccination is recommended for all adults; however, little is known about how primary care physicians can communicate effectively with patients about influenza vaccination. OBJECTIVE:To assess among general internal medicine (GIM) and family physicians (FP) regarding adult influenza vacci...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05164-7
更新日期：2019-10-01 00:00:00
abstract：OBJECTIVE:To describe how medical residents discuss do-not-resuscitate (DNR) orders with patients. DESIGN:Prospective observational study. SETTING:Inpatient medical wards of one university tertiary care center, one urban city public hospital, and one Veterans Affairs medical center. PARTICIPANTS:Thirty-one medical r...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599915
更新日期：1995-08-01 00:00:00
abstract：OBJECTIVE:To determine whether students who take ambulatory rotations in internal medicine are more likely to choose internal medicine careers. DESIGN:National survey. SETTING AND PARTICIPANTS:The intended sample was 1,650 senior U.S. medical students from 16 medical schools, of whom 1,244 (76%) responded. Representa...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/BF02640362
更新日期：1995-10-01 00:00:00
abstract：BACKGROUND:Veterans commonly receive care from both Veterans Health Administration (VA) and non-VA sources (i.e., dual use). A major challenge in comparing health outcomes between dual users and VA-predominant users is applying an accurate method of risk adjustment. OBJECTIVE:To determine how different comorbidity ind...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-017-4064-4
更新日期：2017-09-01 00:00:00
abstract：:Chronic eosinophilic pneumonia (CEP) is a rare interstitial lung disease characterized by subacute dyspnea, peripheral infiltrates on imaging, and pulmonary eosinophilia. We report a case of a 48-year-old man who presented to a "minute clinic" with cough and dyspnea. After improvement on a short course of steroids for...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-012-2316-x
更新日期：2013-07-01 00:00:00
abstract：:Electronic Nicotine Delivery Systems (ENDS), commonly referred to as "e-cigs," were first introduced in the United States in 2007. Since then, their use has grown substantially, with the largest market among adolescents and young adults. ENDS are often perceived by the public as safe alternatives to traditional cigare...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05462-0
更新日期：2020-01-01 00:00:00
