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Preventing type II diabetes mellitus.

L Michael Prisant1

  • 1Hypertension and Clinical Pharmacology, Medical College of Georgia, Augusta, GA 30912, USA.

Journal of Clinical Pharmacology
|March 31, 2004
PubMed
Summary

Intensive lifestyle interventions, including exercise and weight reduction, are most effective in preventing type II diabetes. Certain medications also show promise in delaying diabetes onset and reducing cardiovascular risks.

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Area of Science:

  • Endocrinology
  • Cardiology
  • Preventive Medicine

Background:

  • Rising obesity rates are driving an increase in type II diabetes mellitus.
  • Diabetes leads to severe complications, including cardiovascular disease, renal disease, blindness, and amputations.
  • Impaired glucose tolerance is a critical window for intervention to prevent diabetes.

Purpose of the Study:

  • To evaluate interventions for preventing type II diabetes in individuals with impaired glucose tolerance.
  • To assess the impact of these interventions on cardiovascular morbidity and mortality.

Main Methods:

  • Review of recent prospective studies on diabetes prevention.
  • Analysis of data from trials such as the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) and Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR).

Main Results:

  • Intense lifestyle interventions (exercise, weight reduction) are highly effective in preventing diabetes.
  • Metformin is less effective than lifestyle interventions.
  • Several medications (acarbose, losartan, orlistat, pravastatin, ramipril, hormone replacement therapy) are associated with reduced diabetes development rates.

Conclusions:

  • Early intervention in impaired glucose tolerance can delay or prevent type II diabetes.
  • Lifestyle modifications are the most effective strategy.
  • Pharmacological agents and hormone replacement therapy may also play a role in diabetes prevention and cardiovascular risk reduction.

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