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Strategies to prevent type 2 diabetes.

Abstract

Type 2 diabetes mellitus is a public health problem of epidemic proportions and its prevalence is on the rise. The typical American born today has a one in three chance of developing type 2 diabetes. This diagnosis is associated with an adverse cardiovascular prognosis and is considered the risk equivalent of established coronary disease. Many risk factors, including the metabolic syndrome, have been implicated in its development. Even in high-risk individuals, type 2 diabetes is a preventable disease. Diet and exercise have been consistently shown to decrease the incidence of diabetes in large randomized controlled studies. Additionally, new-onset diabetes was reduced by several oral pharmacologic anti-diabetic agents including metformin, acarbose and troglitazone in randomized trials which studied patients with impaired glucose tolerance. More interestingly, multiple large prospective studies have also reported a reduction in the development of type 2 diabetes in patients treated with anti-hypertensive agents, predominantly angiotensin converting enzyme inhibitors and angiotensin receptor blockers. In this review, we will discuss some of these important trials and the speculative mechanisms whereby those medications prevent type 2 diabetes. Such observations, if proven to be true, may represent preventive strategies which can be considered in patients with pre-diabetic conditions such as the metabolic syndrome, hypertension, impaired fasting glucose, family history of diabetes, obesity, congestive heart failure or other risks for the development of type 2 diabetes.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Mid America Heart Institute, Cardiovascular Consultants, Kansas City, MO 64111, USA. abuissah@umkc.edu

    ,

    Source

    Current medical research and opinion 21:7 2005 Jul pg 1107-14

    MeSH

    Antihypertensive Agents
    Diabetes Mellitus, Type 2
    Glucose Intolerance
    Humans
    Hypoglycemic Agents
    Incidence
    Life Style
    Prediabetic State
    Randomized Controlled Trials as Topic
    Risk Factors
    Risk Reduction Behavior

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    16004680

    Citation

    TY - JOUR T1 - Strategies to prevent type 2 diabetes. AU - Abuissa,Hussam, AU - Bel,David S H, AU - O'keefe,James H,Jr PY - 2005/7/12/pubmed PY - 2005/9/27/medline PY - 2005/7/12/entrez SP - 1107 EP - 14 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 21 IS - 7 N2 - Type 2 diabetes mellitus is a public health problem of epidemic proportions and its prevalence is on the rise. The typical American born today has a one in three chance of developing type 2 diabetes. This diagnosis is associated with an adverse cardiovascular prognosis and is considered the risk equivalent of established coronary disease. Many risk factors, including the metabolic syndrome, have been implicated in its development. Even in high-risk individuals, type 2 diabetes is a preventable disease. Diet and exercise have been consistently shown to decrease the incidence of diabetes in large randomized controlled studies. Additionally, new-onset diabetes was reduced by several oral pharmacologic anti-diabetic agents including metformin, acarbose and troglitazone in randomized trials which studied patients with impaired glucose tolerance. More interestingly, multiple large prospective studies have also reported a reduction in the development of type 2 diabetes in patients treated with anti-hypertensive agents, predominantly angiotensin converting enzyme inhibitors and angiotensin receptor blockers. In this review, we will discuss some of these important trials and the speculative mechanisms whereby those medications prevent type 2 diabetes. Such observations, if proven to be true, may represent preventive strategies which can be considered in patients with pre-diabetic conditions such as the metabolic syndrome, hypertension, impaired fasting glucose, family history of diabetes, obesity, congestive heart failure or other risks for the development of type 2 diabetes. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/16004680/full_citation L2 - http://www.tandfonline.com/doi/full/10.1185/030079905X50606 ER -