Drug could prevent type 2 diabetes in high-risk individuals

Giving people at high-risk of developing type 2 diabetes a drug called rosiglitazone, along with lifestyle recommendations, could substantially reduce their chances of developing the disease, according to an Online/Article published by The Lancet today (Friday September 15, 2006).

Type 2 diabetes develops when people cannot produce enough of the hormone insulin or when the insulin that their body does make does not work properly. This lack of insulin means they are unable to utilise glucose in the normal way. People with two conditions that impair their regulation of glucose - impaired glucose tolerance or impaired fasting glucose - have a high risk of developing type 2 diabetes. More than 8% of people worldwide have these two conditions, and about 5-10% of these people will develop diabetes every year.

In the DREAM trial, Canadian investigators randomised 5269 adults with impaired glucose tolerance or impaired fasting glucose to receive rosiglitazone or placebo daily for three years. At regular intervals throughout the study the researchers emphasised the importance of a healthy diet and lifestyle to the participants. They found that 280 individuals on rosiglitazone and 658 on placebo developed diabetes. There was a small excess risk of non-fatal heart failure in the drug group when compared to the placebo group.

The authors conclude: "The results of this study suggest that the addition of rosiglitazone to basic lifestyle recommendations substantially reduces the risk of developing diabetes by about two-thirds, offering a novel preventive approach…Balancing both the benefits and the risks suggests that for every 1000 people treated with rosiglitazone for 3 years, about 144 cases of diabetes will be prevented, with an excess of four to five cases of congestive heart failure."

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Contact: Dr Hertzel C Gerstein, DREAM Project Office, Population Health Research Institute (at McMaster University and Hamilton Health Sciences), 237 Barton Street East, 2nd Floor, Hamilton, Ontario, L8L 2X2, Canada, dream@cardio.on.ca or gerstein@mcmaster.ca Dr Gerstein is currently in Copenhagen and can be reached by email.

Notes to editors

The results of the DREAM trial are being presented at the 42nd Annual Meeting of the European Association for the Study of Diabetes in Copenhagen, September 14-17, 2006. The embargo coincides with the presentation.


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