Posted on 09/17/2006 6:57:42 PM PDT by neverdem
ASSOCIATED PRESS
The largest diabetes prevention study ever done has found that a drug already used to treat the disease also can help keep "pre-diabetics" from developing it. But many experts say losing weight and exercising remain a safer, cheaper approach.
The drug, rosiglitazone, or Avandia, appeared to cut the risk of developing Type 2 diabetes by more than half, doctors reported Friday. Type 2 is the most common form of diabetes, afflicting more than 200 million people worldwide.
Avandia also helped restore normal blood-sugar function in many of those who took it.
A second part of the study found that a different drug, a blood pressure medication called ramipril, or Altace, made no difference in the risk of developing diabetes but helped normalize blood sugar for some.
The research was long awaited, and the Avandia results at first glance seem impressive. However, experts say it is difficult to determine how much of the improvement was the owing to the drug, because study volunteers also were counseled about healthy diets and lifestyles.
"We know that lifestyle changes alone can reduce the risk of developing diabetes by up to 58 percent," said Dr. Martin Abrahamson, medical director of the Joslin Diabetes Center in Boston, who had no ties to the study.
Those benefits come without the $90- to $170-a-month cost and side effects of Avandia, said Dr. Alvin Powers, director of diabetes research at Vanderbilt University Medical Center, who also had no role in the research.
"Fluid retention, congestive heart failure, and weight gain are known side effects of Avandia" when it's used to treat diabetes, Powers noted.
Results of the study were reported Friday at a diabetes meeting in Denmark. The Avandia findings were published online by the British medical journal The Lancet; the Altace results were posted online by the New England Journal of Medicine. The study was paid for by the Canadian Institutes of Health Research and companies that make the drugs. (GlaxoSmithKline PLC makes Avandia; Sanofi-Aventis SA and King Pharmaceuticals market Altace.) Some study leaders consult for the companies.
The aim was preventing Type 2 diabetes, the form that is linked to obesity and sometimes leads to kidney failure, amputations and death. It occurs when the body does not make enough insulin or cannot effectively use what it manages to produce.
Research suggests that as many as half of pre-diabetics develop diabetes within three years.
Still, some doctors were encouraged by Avandia's potential.
"This underscores the fact that diabetes is preventable, and that we might have another means to do that with," said Dr. Peter Sheehan, director of diabetes at the Cabrini Medical Center in New York, who had no ties to the study.
Dr. Jeffrey Probstfield, a University of Washington professor who led the U.S. portion of the study, said he would advise pre-diabetics to try the drug.
"I'm a strict adherent to the lifestyle approach," but the drug adds one more tool people can use to avoid a deadly and disabling disease, he said.
The DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators*
Summary
Background Rosiglitazone is a thiazolidinedione that reduces insulin resistance and might preserve insulin secretion. The aim of this study was to assess prospectively the drug’s ability to prevent type 2 diabetes in individuals at high risk of developing the condition.
Methods
5269 adults aged 30 years or more with impaired fasting glucose or impaired glucose tolerance, or both, and no previous cardiovascular disease were recruited from 191 sites in 21 countries and randomly assigned to receive rosiglitazone (8 mg daily; n=2365) or placebo (2634) and followed for a median of 3 years. The primary outcome was a composite of incident diabetes or death. Analyses were done by intention to treat. This trial is registered at ClinicalTrials.gov, number NCT00095654.
Findings
At the end of study, 59 individuals had dropped out from the rosiglitazone group and 46 from the placebo group. 306 (11·6%) individuals given rosiglitazone and 686 (26·0%) given placebo developed the composite primary outcome (hazard ratio 0·40, 95% CI 0·35–0·46; p<0·0001); 1330 (50·5%) individuals in the rosiglitazone group and 798 (30·3%) in the placebo group became normoglycaemic (1·71, 1·57–1·87; p<0·0001). Cardiovascular event rates were much the same in both groups, although 14 (0·5%) participants in the rosiglitazone group and two (0·1%) in the placebo group developed heart failure (p=0·01).
Interpretation
Rosiglitazone at 8 mg daily for 3 years substantially reduces incident type 2 diabetes and increases the likelihood of regression to normoglycaemia in adults with impaired fasting glucose or impaired glucose tolerance, or both
Glucose lowering and diabetes prevention: are they the same? editorial in pdf format, just 2 pages
Effect of Ramipril on the Incidence of Diabetes article in pdf format
Background
Previous studies have suggested that blockade of the renin–angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension.
Methods
In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we randomly assigned 5269 participants without cardiovascular disease but with impaired fasting glucose levels (after an 8-hour fast) or impaired glucose tolerance to receive ramipril (up to 15 mg per day) or placebo (and rosiglitazone or placebo) and followed them for a median of 3 years. We studied the effects of ramipril on the development of diabetes or death, whichever came first (the primary outcome), and on secondary outcomes, including regression to normoglycemia.
Results
The incidence of the primary outcome did not differ significantly between the ramipril group (18.1%) and the placebo group (19.5%; hazard ratio for the ramipril group, 0.91; 95% confidence interval [CI], 0.81 to 1.03; P = 0.15). Participants receiving ramipril were more likely to have regression to normoglycemia than those receiving placebo (hazard ratio, 1.16; 95% CI, 1.07 to 1.27; P = 0.001). At the end of the study, the median fasting plasma glucose level was not significantly lower in the ramipril group (102.7 mg per deciliter [5.70 mmol per liter]) than in the placebo group (103.4 mg per deciliter [5.74 mmol per liter], P = 0.07), though plasma glucose levels 2 hours after an oral glucose load were significantly lower in the ramipril group (135.1 mg per deciliter [7.50 mmol per liter] vs. 140.5 mg per deciliter [7.80 mmol per liter], P = 0.01).
Conclusions
Among persons with impaired fasting glucose levels or impaired glucose tolerance, the use of ramipril for 3 years does not significantly reduce the incidence of diabetes or death but does significantly increase regression to normoglycemia. (ClinicalTrials.gov number, NCT00095654.)
Do a web search on health benefits of cinnamon.
That was over a year ago and, so far, the results are good. Seems to help a lot, but it's no miracle cure.
Cool. Now we can sit on our a$$e$ more and live longer. And someone else will probably pay for it ;-) I am sure it will help some people who can't get proper exercise.
"Rosiglitazone" sounds like an Italian name. Didn't Tony Rosiglitazone play MLB?
My daughter-in-law took Avandia. It gave her diarrhea and persistent, painful headaches. Think twice...
The reason is you will most likely get a heart attack.
You have to stop the one, wait some period of time, and start the other.
I'd say your physician could advise you how long that might be and there doesn't seem to be any information on the net concerning the matter.
So, it's not just a potential "side effect" ~ you can induce a heart attack simply switching from one drug to the other.
Cinnamon seems to knock your blood sugar highs back about 50 points. You still need to exercise to get the lows down.
It sure has worked for my wife, and it's been way over a year and we almost take it for granted now.
And nobody ever complains about the taste. I have never met anyone who doesn't like cinnamon.
HA...YOU beat me to it.....CINNAMON!!!!
Cinnamon is also supposed to lower cholesterol. Mine was 235 before Lipitor. After Lipitor it was 175. After Lipitor & 2 teaspoons of cinnamon a day is is now 120.
Cinnamon is cheap & tastes good so what the hell.
No, but his uncle is Fat Louie (from the south side), so if he wants to play MLB he will be doing it anytime he wants to.
Also, notice that in the article at the beginning of this thread it discusses "side effects" which include "Fluid retention, congestive heart failure, and weight gain".
Bet you thought none of that applied to you. Ask your doctor.
Sounds like what my ex-wife gave me. Dang right to think twice (I did the next time).
I added cinnamon to my routine 2 months ago... knocked my blood sugar and LDL down big time... hasn't helped increase the HDL however... cinnamon is a great spice! Leaves your breath kissable sweet as well!
The reason is you will most likely get a heart attack.
Ouch!
That includes walnuts, hickory nuts, pecans, fatty fish, and "brown eggs".
Yes, it's true ~ brown eggs actually did taste better, and richer, because they had more omega 3 fatty acids than the white eggs.
Not everybody could taste the difference though.
For those of you who mentioned cinnamon, how are you taking it and in what quantities?
How are you eating 2 teaspoons of cinnamon a day? What do you put it on/in? I could use some suggestions.
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