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Primary Prevention of Type 2 Diabetes: Lifestyle Intervention Works and Saves Money, but What Should Be Done with Smokers?

Jaakko Tuomilehto, MD, PhD, MPolSc
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From University of Helsinki, National Public Health Institute, Helsinki, Finland, and South Ostrobothnia Central Hospital, Seinajöki, Finland.

Grant Support: By the Academy of Finland (46558).

Potential Financial Conflicts of Interest: Honoraria: Merck & Co., Inc.; Stock ownership or option (other than mutual funds): Orion Pharma; Grants received: AstraZeneca, Novartis.

Requests for Single Reprints: Jaakko Tuomilehto, MD, PhD, MPolSc, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland; e-mail, jaakko.tuomilehto@ktl.fi.

Ann Intern Med. 2005;142(5):381-383. doi:10.7326/0003-4819-142-5-200503010-00013
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Reducing the risk factors that diseases have in common may prove to be an efficient prevention strategy (12). For example, major risk factors, including obesity, physical inactivity, smoking, hypertension, hyperglycemia, and hyperlipidemia, predict the development of several chronic diseases, such as cardiovascular disease, cancer, diabetes, and dementia (35). Although one risk factor may confer a greater risk for a certain disease outcome than another risk factor, these risk factors are correlated and seem to operate in concert. A successful preventive intervention must, therefore, target several risk factors simultaneously (2, 6). This characteristic of preventive interventions means that they are necessarily complex and require considerable resources.

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