Abstract
Early intervention for preservation of pancreatic β-cell function is crucial for strict glycemic control without hypoglycemia. Early intervention consists of two approaches, change of life style and drug therapy. Especially, diet therapy is important for body weight reduction. However, adherence of calorie restriction in obese patients is still low and a new approach is necessary. Improvement of life style including body weight reduction produces not only improvement of glycemic control but also prevention of incidence of diabetes. This preventive effect is recognized in patients who have many risk alleles associating with type 2 diabetes, indicating that early intervention of life style can overcome genetic risk for diabetes. Moreover, in order to maintain an appropriate life style for a long time, patients need motivation and empowerment to perform the daily management of diabetes. Therefore, we need more efficient use of Conversation Map which helps patients follow a treatment over a long period of time, or helps them change “an aspect of their lifestyle”. Finally, in addition to intervention of life style, early intervention by insulin treatment is important for the preservation of pancreatic β-cell function, however, initiation of insulin is often delayed mainly due to patients' hesitation even in insufficient glycemic control. In future, insulin treatment will need to become more popular in general physicians.
