In this Article

• Introduction to diabetes prevention
• What is type 2 diabetes?
• What are the risks factors for developing diabetes?
• Are there any "red flags" we can measure that point to an increased risk for diabetes?
• Is gestational diabetes a risk for developing type 2 diabetes later in life?
• Are certain dietary patterns associated with the development of type 2 diabetes?
• Is there anything that can help to prevent the onset of type 2 diabetes?
• Are there medications that can help to prevent type 2 diabetes?
• Type 2 Diabetes Prevention At A Glance
• Diabetes Prevention Glossary
• Diabetes Prevention Index

Are there medications that can help to prevent type 2 diabetes?

The answer is yes.

As described above, metformin has been shown in the DPP trial to prevent the development of diabetes in those with impaired glucose tolerance. While not quite as effective as intensive lifestyle change, metformin decreased the rate of progression from 29% in the placebo group to 22%.

Another class of drugs called the thiazolidinediones [pioglitazone (Actos) and rosiglitazone (Avandia)] has been shown to be beneficial in prevention of type 2 diabetes. Drugs in this class have also been studied extensively in patients who have had gestational diabetes, and there is a significant reduction in the annual rates of progression to diabetes (5.4% compared to 12.1% with placebo).

Acarbose (Precose), a drug designed to reduce small intestinal absorption of carbohydrates has been used with some success as well. The STOP NIDDM trial showed that in about 1400 patient with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo.

Interestingly, drugs that were not initially thought to have much to do with insulin and glucose regulation are also being shown to be beneficial in prevention of type 2 diabetes. One of the most discussed class of drugs are ACE Inhibitors. A large trial known as the HOPE trial was recently published. The aim of this trial was to focus on the effects of one of these drugs on the heart and blood vessels. However, when they reviewed the data, they also found that those on medication therapy had fewer occurrences of diabetes than those receiving placebo. This has also been noted in a similar class of drugs called angiotensin converting blockers. The mechanism of this benefit is being explored.