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Ruth Colagiuri, RN, BEd, Stephen Colagiuri, MD, Derek Yach, MBChB, MPH and Stig Pramming, MD

Ruth Colagiuri is with the Australian Health Policy Institute, University of Sydney, Sydney, Australia. Stephen Colagiuri is with the Department of Endocrinology, Diabetes and Metabolism, Prince of Wales Hospital, Randwick, Australia. At the time this article was written, Derek Yach was with the Department of Global Health, Yale School of Public Health, New Haven, Conn. Stig Pramming is with the Oxford Health Alliance, Oxford, England.

Correspondence: Requests for reprints should be sent to Ruth Colagiuri, RN, BEd, Diabetes Unit, Australian Health Policy Institute, Victor Coppleson Building, D02, University of Sydney, Sydney NSW 2006, Australia (e-mail: rcolagiuri{at}med.usyd.edu.au).

The diabetes and obesity epidemics are closely intertwined. International randomized controlled trials demonstrate that, in high-risk individuals, type 2 diabetes can be prevented or at least delayed through lifestyle modification and, to a lesser degree, medication. We explored the relative roles of science, surgery, service delivery, and social policy in preventing diabetes.

Although it is clear that there is a role for all, diabetes is a complex problem that demands commitment across a range of government and nongovernment agencies to be effectively controlled. Accordingly, we argue that social policy is the key to achieving and sustaining social and physical environments required to achieve widespread reductions in both the incidence and prevalence of diabetes.

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