Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial

Standards of care for type 2 diabetes in China

“…Drug intervention trials in a pre‐diabetic population showed that the oral administration of hypoglycaemic agents, such as metformin, α ‐glucosidase inhibitors, thiazolidinediones (TZDs), metformin combined with TZDs, the diet pill orlistat and traditional Chinese herbal medicine (Tianqi capsules), reduced the risk of diabetes 13, 17, 18, 19, 20, 21. However, because there is no sufficient evidence showing that drug interventions have long‐term efficacy and/or health economics benefits, the clinical guidelines developed by various countries have not widely recommended medical interventions as the primary prevention for diabetes.…”

Targeting beta-cell preservation in the management of type 2 diabetes

“…91 Preservation of beta-cell function, in addition to insulin-sensitising effects, means that TZDs can slow progression of IGT to T2D by 50-75% in high-risk individuals. [92][93][94] Patients protected from diabetes with TZD therapy had stable beta-cell function and stable insulin resistance for up to five years. 95 The durability of effect of TZDs on beta-cell function in T2D is not clear; longer term studies of TZDs indicate that improvements in beta-cell function are sustained over two years in individuals with T2D uncontrolled with metformin or sulphonylurea monotherapy.…”

Clinical Trials in Veterinary Medicine: A New Era Brings New Challenges

“…One study35 evaluated human patients with diabetes at risk for heart disease with a composite endpoint of nonfatal myocardial infarction or coronary‐related death, and found that treatment significantly lowered the risk of nonfatal infarction by 24%, but the rate of coronary‐related death tended to increase in patients receiving treatment. Another example from human medicine is a study36 that reported that treatment with an insulin sensitizer significantly decreased risk of a composite endpoint consisting of new onset of diabetes or death by 60%. An accompanying editorial28 raised the following important issues: was there a decrease in both diabetes and death and were the 2 outcomes just as likely to occur?…”

“…An accompanying editorial28 raised the following important issues: was there a decrease in both diabetes and death and were the 2 outcomes just as likely to occur? It turned out that >94% of the outcomes experienced by the study participants were onset of diabetes, and whereas the relative risk of developing diabetes in patients receiving treatment was significantly decreased at 0.40 (95% confidence interval [CI], 0.35−0.46), the relative risk of death associated with treatment appeared unchanged at 0.91 (95% CI, 0.55−1.49) 36. Despite the use of the composite endpoint, these examples clearly provide almost no information about the treatment effect on death, and the treatment should not be promoted as preventing mortality.…”