May 1, 2016
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Diabetes Prevention (cont.)

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

  • As described previously, metformin (Glucophage) 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.
    • High-risk individuals are those under 60 years of age or who are obese, or women with a history of gestational diabetes who have impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or Hemoglobin A1C levels of 5.7 to 6.4 percent, in whom lifestyle interventions fail to improve control of glucose levels.
  • Acarbose (Precose), a drug designed to reduce small intestinal absorption of carbohydrates has been used with some success as well and is licensed for diabetes prevention in some countries. The STOP NIDDM trial showed that in about 1400 patients with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo. However, the occurrence of gastrointestinal side effects have limited the use of this drug for some people.

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.

Medscape. Metformin underused in patients with prediabetes. May 01, 2015
<http://www.medscape.com/viewarticle/844072>

Medscape. Inflammatory marker profile shifts as type 2 diabetes develops. May 01, 2015.
<http://www.medscape.com/viewarticle/844081>


Medically Reviewed by a Doctor on 4/14/2016

Source: MedicineNet.com
http://www.medicinenet.com/diabetes_prevention/article.htm

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