84.941 enfermeirase seguimento de 16 anos, o controle de fatores de risco modificaveis, como dieta habitual,atividade fisica, tabagismo e excesso de peso,foi associado a reducao de 91% na incidenciade DM e de 88% nos casos com historia familiar de DM(11) (B, 1).Quanto a prevencao secundaria, existemevidencias de que o controle metabolico estrito tem papel importante na prevencao dosurgimento ou da progressao de suas complicacoes cronicas, conforme ficou demonstradopelo Diabetes Control and Complications Trial(DCCT)(12) para o DM1 e pelo United KingdomPropective Diabetes Study (UKPDS)(13) para oDM2 (B, 1).Outras medidas importantes na preven-cao secundaria(14) sao: tratamento da hipertensao arterial e da dislipidemia, o que reduz substancialmente orisco de complicacoes do DM (B, 1); prevencao de ulceracoes nos pes e de amputacoes de membros inferiores atraves de cuidados especificos que podem reduzir tanto a frequencia e a duracao de hospitalizacoes como,em 50%, a incidencia de amputacoes (B, 2);Diretrizes sbD 2006102006 Diretrizes sbD11rEFErEnCiasBiBLioGraFiCas1. Wild S, Roglic G, Green A, Sicree R, King H. Globalprevalence of diabetes. Estimates for the year2000 and projections for 2030. Diabetes Care.2004; 27(5): 1047-53.2. Malerbi D, Franco LJ; the Brazilian CooperativeGroup on the Study of Diabetes Prevalence.Multicenter Study of the Prevalence ofDiabetes Mellitus and Impaired GlucoseTolerance in the urban Brazilian populationaged 30-69 years. Diabetes Care. 15(11):1509-16, 1992.3. Torquato MTCG, Montenegro Jr RN, Viana LAL,Souza RAHG, Ianna CMM, Lucas JCB, et al.Prevalence of diabetes mellitus and impairedglucose tolerance in the urban populationaged 30-69 years in Ribeirao Preto (Sao Paulo),Brazil. Sao Paulo Med J. 2003; 121(6): 224-30.4. Gimeno SGA, Ferreira SRG, Cardoso MA, FrancoLJ, Iunes M; the Japanese-Brazilian DiabetesStudy Group. Weight gain in adulthood andrisk of developing glucose disturbance astudy of a Japanese-Brazilian population. JEpidemiol. 2000; 10(2 ): 103-10.5. Onkamo P, Vaananen S, Karvonen M, TuomilehtoJ. Worldwide increase in incidence of type 1diabetes: the analysis of the data on publishedincidence trends. Diabetologia. 1999; 42(12):1395-403.6. Franco LJ. Um problema de saude publica.Epidemiologia. In: Oliveira JEP, Milech A,editors. Diabetes mellitus: clinica, diagnostico,tratamento multidisciplinar. Sao Paulo: EditoraAtheneu; 2004. cap. 4, p. 19-32.7. Schramm JMA, Oliveira AF, Leite IC, ValenteJG, Gadelha AMJ, Portela MC, Campos MR.Transicao epidemiologica e o estudo de cargade doenca no Brasil. Ciencia & Saude Coletiva.2004; 9(4): 897-908.8. Barcelo A, Aedo C, Rajpathak S, Robles S. The costof diabetes in Latin America and the Caribean.Bull World Health Organ 2003; 81(1): 19-27.9. Diabetes Prevention Program Research Group.Reduction of the incidence of type 2 diabeteswith life style intervention or metformin. NEngl J Med. 2002; 346(6): 393-403.10. Tuomilehto J, Lindstrom J, Eriksson JG,Valle TT, Hamalainen H, Hanne-Parikka P,Keinanen-Kiukaanniemi S; for the FinnishDiabetes Prevention Program. Prevention oftype 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucosetolerance. N Engl J Med. 2001; 344(18):1343-50.11. Hu EB, Manson JE, Stamper MJ, Colditz G, LiuS, Solomon CG, Willett WC. Diet, lifestyle, andthe risk of type 2 diabetes mellitus in women.N Engl J Med. 2001; 345(11): 790-7.12. The Diabetes Control and ComplicationsTrial Research Group. The effect of intensivetreatment of diabetes on the developmentand progression of long-term complicationsin insulin-dependent diabetes mellitus. NEngl J Med. 1993; 329(14): 977-86.13. UK Prospective Diabetes Study (UKPDS)Group. Intensive blood glucose controlwith sulphonylureas or insulin comparedwith conventional treatment