Low dose of diabetes drugs may help avert the disease
THE QUESTION Might a combination of drugs used to treat Type 2 diabetes help prevent the disease in people considered on the verge of developing the disease?
THIS STUDY involved 207 adults with pre-diabetes, meaning they had blood sugar levels near the threshold for a diabetes diagnosis. None had ever taken diabetes medications. They were randomly assigned to take a combination of metformin and rosiglitazone (Avandia), at half the maximum dose, or a placebo daily. Both groups also participated in classes and were given materials on lifestyle changes, mainly weight loss and exercise, that might improve their condition. After about four years, 14 percent of people taking the medication had developed diabetes, compared with 39 percent of those taking the placebo. Also, the body's ability to convert blood sugar to energy had returned to normal in about 80 percent of those in the medication group, vs. 53 percent of the others. Virtually no differences between the groups were found for side effects common with higher drug doses, including weight gain, heart problems and broken bones. Diarrhea occurred more often among those taking the drugs.
WHO MAY BE AFFECTED? People with pre-diabetes, who have higher-than-normal blood sugar levels but often have no symptoms. Nearly 60 million people in the United States are believed to have pre-diabetes.
CAVEATS The study may not have lasted long enough to assess risks for heart failure, heart attack and fractures that have been associated with larger medication dosages. The study was funded by GlaxoSmithKline, which makes Avandia, and three of the eight authors had received fees from the company.
FIND THIS STUDY June 3 online issue of the Lancet.
-- Linda Searing
The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.