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An international trial has found that taking the drug rosiglitazone can reduce the chance of people getting type 2 diabetes by up to two thirds among those at high risk.
Type 2 diabetes is strongly associated with obesity and is increasing on the scale of a global epidemic. It is diagnosed in more than 5 per cent of all adults, accounting for 85 to 95 per cent of all diabetes cases, and this rate is rising rapidly throughout the world. In addition, about 300 million people worldwide are estimated to have an impaired ability to regulate their use of glucose, a condition sometimes referred to as “pre-diabetes”, which puts them at especially high risk of developing the disease.
The Diabetes Reduction Assessment with Medication (Dream) trial, which was co-ordinated by the University of Oxford and the Canadian Cardiovascular Collaboration at McMaster University, was published online yesterday by the The Lancet medical journal. The study included 5,269 people at 191 clinics in 21 countries whose average age was 55 and whose glucose level was starting to rise but who did not have diabetes.
Participants took rosiglitazone, also known by the brand name Avandia, or a dummy placebo, while taking lifestyle advice. Over a period of three years, only 12 per cent of those taking rosiglitazone developed diabetes, compared with 26 per cent who became diabetic while taking the placebo. Rosiglitazone was also found to return glucose levels to normal in 51 per cent of participants versus 30 per cent of those taking a placebo.
It was found to benefit all the patients, and particularly those who weighed the most. However, a small risk of non-fatal and treatable heart failure was also associated with the drug.
The research team were led by Hertzel Gerstein from the Population Health Research Institute in Hamilton, Ontario, whose findings were presented to the annual meeting of the European Association for the Study of Diabetes in Copenhagen yesterday.
Rosiglitazone is a drug from the thiazolidinediones family and is currently used to treat diabetes once it is diagnosed.
However, scientists writing in The Lancet said that a more common side affect of the drug was weight gain. “Although this weight gain might be associated with a more favourable distribution of fat, it is a concern,” wrote Jaakko Tuomilehto, of the University of Helsinki, Finland, and Nicolas Wareham of the University of Cambridge.
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