Prevention of type 2 diabetes: An update

Abstract

With the rising tide of the diabetes epidemic leading to increased morbidity and mortality (primarily from cardiovascular disease), together with failure to control the disease and its associated complications, prevention of diabetes appears to be the logical option for curbing this epidemic. Several trials have been completed, and others ongoing, using various strategies for diabetes prevention. In this review, we provide an update on diabetes prevention strategies, highlighting the rationale behind such interventions, together with an outlook of the ongoing efforts that are likely to provide additional options for patients at risk for diabetes.

Prevention and current onset delay approaches of type 2 diabetes mellitus (T2DM)

“…The HOPE (Heart Outcomes Prevention Evaluation) study showed that ramipril, 10 mg daily for 4.5 years, reduced the incidence of T2DM by 34% in non-diabetic individuals with CVD compared with placebo [16,39]. Similar glycemic protective effects were found with captopril (in the CAptopril Prevention Project, CAPPP), lisinopril (in the Antihypertensive and LipidLowering Treatment to Prevent Heart Attack Trial, ALLHAT) and losartan (in the Losartan…”

“…The discrepancy in findings between the DREAM trial and previous reports may be related to the difference in the study design and study population [16]. In the DREAM trial, diabetes prevention was a primary outcome and ramipril was compared with placebo.…”

“…Another trial, conducted by the Diabetes Prevention Program (DPP) Research Group, enrolled 3234 overweight adults with pre-diabetes [14][15][16]. Participants were randomized following a lifestyle modification program aiming to achieve a 7% weight loss, taking metformin 850 mg twice a day, or matching placebo [17].…”

“…The Troglitazone in Prevention of Diabetes (TRIPOD) study randomized 266 Hispanic women with previous gestational diabetes to troglitazone or placebo [16,25]. The authors showed a reduction greater than 50% of T2DM incidence after 1.5 years of follow-up in troglitazone group.…”

“…Glucose Tolerance Outcomes Research (NAVIGATOR) study is a multinational, randomized, double-blind trial in subjects with IGT, with or older than 50 years old with known CVD or with or older than 55 years old with CVD risk factor of or above 1 [16,31]. This study was designed to evaluate whether reducing postprandial hyperglycemia, blockade of the renin-angiotensinaldosterone system, or both interventions reduced the risk of T2DM or cardiovascular events in 8 patients with IGT.…”