Glucose lowering and diabetes prevention: are they the same?

Abstract

The prevention of type 2 diabetes is a major public-health issue. The results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial, 1 DREAM trial investigatorsEffect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet. 2006; published online Sept 15. DOI:10.1016/S0140-6736(06)69420-8 Google Scholar show that progression to diabetes in people with impaired glucose regulation can be diminished. The relative risk reduction of rosiglitazone seen in DREAM was similar to that obtained by lifestyle interventions 2 Tuomilehto J Lindström J Eriksson JG et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344: 1343-1350 Crossref PubMed Scopus (8312) Google Scholar , 3 The Diabetes Prevention Program Research GroupReduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346: 393-403 Crossref PubMed Scopus (14420) Google Scholar , 4 Ramachandran A Snehalatha C Mary S Mukesh B Bhaskar AD Vijay V The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006; 49: 289-297 Crossref PubMed Scopus (1316) Google Scholar , 5 Eriksson KF Lindgärde F Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. Diabetologia. 1991; 34: 891-898 Crossref PubMed Scopus (1015) Google Scholar and much the same as that seen in two previous trials of the now withdrawn thiazolidinedione troglitazone. 6 Buchanan TA Xiang AH Peters RK et al. Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women. Diabetes. 2002; 51: 2796-2803 Crossref PubMed Scopus (1204) Google Scholar , 7 The Diabetes Prevention Program Research GroupPrevention of type 2 diabetes with troglitazone in the Diabetes Prevention Program. Diabetes. 2005; 54: 1150-1156 Crossref PubMed Scopus (402) Google Scholar Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trialRosiglitazone at 8 mg daily for 3 years substantially reduces incident type 2 diabetes and increases the likelihood of regression to normoglycaemia in adults with impaired fasting glucose or impaired glucose tolerance, or both. Full-Text PDF Open Access