University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Urgent Care


Dr. Tom Colletti



Objective: The purpose of this article is to review evidence-based literature on the reduction of type 2 diabetes (T2DM) in pre-diabetes (preDM) through lifestyle modifications and the prevention of microvascular and macrovascular complications.

Methods: Randomized controlled trials were reviewed on the current recommendations for diet, physical activity, and weight reduction in preDM to prevent T2DM and its complications. The review was conducted using a database search on evidence-based literature to include PubMed, British Medical Journal, and Google Scholar. The articles selected are peer-reviewed, between 2017-2019, and several focused on lifestyle modifications versus medications. A work librarian was consulted on article organization.

Results: Studies show that the onset of diabetes can be reduced with weight loss through lifestyle modifications. The studies also confirm lifestyle modifications are superior to metformin. There is a connection between microvascular and macrovascular disease in pre-diabetes.

Conclusion: All studies were successful in demonstrating that lifestyle modifications are essential in managing pre-diabetes. Weight loss is the key, and more specifically at ≥5%, in the prevention of T2DM. The lifestyle modification programs discussed are realistic and can be coordinated by clinicians in primary care. Microvascular and macrovascular diseases were often discovered at the diagnosis of type 2 diabetes. The link between pre-diabetes and cardiovascular disease (CVD) has been established. Clinicians should be aware of the outcomes for their patients.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.