Preventing Type 2 Diabetes

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Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial, by the DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators. Lancet 368:1096–1105, 2006.

What is the problem and what is known about it so far?

The diabetes rate is growing in the U.S., as are the complications that go along with the disease. These complications include damage to the eyes, kidneys, nerves, and cardiovascular disease (CVD, disease of the heart and blood vessels).

Although there are drugs to treat diabetes, there are no drugs approved by the Food and Drug Administration (FDA) to treat people with pre-diabetes whose bodies don’t handle glucose and insulin well.

But one drug, rosiglitazone, may be able to help. Rosiglitazone stimulates cells that make insulin.

Why did the researchers do this particular study?

The researchers wanted to see whether treatment with rosiglitazone, along with a healthy diet and exercise, delayed the development of diabetes in people with pre-diabetes.

Who was studied?

The study included 5,269 people with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), both of which are forms of pre-diabetes. Participants were recruited from 191 medical centers in 21 countries.

How was the study done?

Half of the participants took 8 mg of rosiglitazone, while half took a placebo. They were followed for an average of three years. During this time, researchers kept track of how many participants developed diabetes, had a cardiovascular event such as heart attack or stroke, or died.

What did the researchers find?

Compared with those who took the placebo, people taking rosiglitazone were 62% less likely to develop diabetes. They were also more than 70% more likely to return to normal blood glucose levels. Very few people had a cardiovascular event or a negative reaction to the drug.

What were the limitations of the study?

The study may have been too brief to assess the long-term effects of rosiglitazone therapy.

What are the implications of the study?

Treatment with rosiglitazone delays the progression of diabetes in people who are likely to develop diabetes.  More research is needed to assess the long-term effects of rosiglitazone to see if the drug reduces the complications of diabetes, and to see if related drugs have the same effect.

FOR MORE INFORMATION

Frequently Asked Questions About Pre-Diabetes

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