We’ve had several blogs on the topic of prevention of type two diabetes (T2D) over the past few years (see Want to live longer, Want to live (even) longer and How to avoid diabetes). The reason for our interest is that T2D looks set to be the fastest growing health issue in North America in the next couple of decades.
Diabetes affects over 150 million people worldwide and this number is expected to double by 2025. In North America, over 90% of all cases of diabetes are T2D.
Short of radical lifestyle changes (strict exercise regimen and substantial weight loss) is there anything we can do to prevent the development of this insidious, life-threatening disease?
A group of Toronto researchers and their colleagues in Hamilton and London have recently shown that combination of two diabetes medications at lowered doses can significantly delay the onset of T2D.
The 207-patient CANOE study, recently published in The Lancet (read here), allocated subjects with at least one risk factor for the development of T2D to treatment with low-dose metformin+rosiglitazone (MR) or placebo and followed various disease parameters over a four-year period.
The results showed that the MR-regimen patients had a significantly lower incidence of development of T2D (14% vs 39%) and had a greater relative risk reduction (66% vs 26%) than patients in the placebo group. In terms of safety, the MR group had a higher incidence of diarrhea compared to the placebo group (16% vs 6%) but there were no clinically significant adverse events. More work will likely have to be conducted to look at the long term cardiovascular safety of this treatment plan.
The authors concluded that the MR regimen seems safe and effective for preventing development of T2D in at risk patients.
The study was supported by GlaxoSmithKline.