Diabetes Prevention (cont.)

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

The answer is yes.

As described previously, 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%. The American Diabetes Association has recommended metformin for the prevention of diabetes in very high-risk individuals.

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). Avandia, however, has been associated with an increased risk of heart attack and stroke, on September 23, 2010, the U.S. Food and Drug Administration (FDA) announced that it will significantly restrict the use of the diabetes drug rosiglitazone (Avandia) to patients with type 2 diabetes who cannot control their diabetes on other medications such as pioglitazone (Actos).

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 patients with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo.

REFERENCES:

American Diabetes Association, Diabetes Care. Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study.

American Diabetes Association, Diabetes Care. The Finnish Diabetes Prevention Study (DPS).

American Diabetes Association, Diabetes Care. The Diabetes Prevention Program (DPP): description of lifestyle intervention.

CDC.gov. Diabetes Facts.

FDA Prescribing Information for Avandia.

Harvard School of Public Health. Study Links Western Dietary Pattern with a Greater Risk for Type 2 Diabetes in Men.

Harvard School of Public Health. Simple Steps to Preventing Diabetes.

WebMD.com. Western Diet Ups Heart, Diabetes Risk.

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Medically Reviewed by a Doctor on 6/5/2012

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