Pre-Diabetic Patients Respond To Agressive Glucose-Lowering Treatment

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Main Category: Diabetes
Article Date: 12 Jun 2012 - 12:00 PST


In 2011, the Centers for Disease Control and Prevention estimated that 79 million Americans have pre-diabetes. Each year 11% of individuals with the condition, which occurs when blood glucose concentrations are higher than normal, but not as high as seen in diabetes, develop diabetes.

Now, researchers have found that people with pre-diabetes are 56% less likely to develop diabetes 5 to 7 years later if they experience a period of normal glucose regulation.

The study, conducted by the Diabetes Prevention Program Research Group, USA, was presented at the American Diabetes Association 72nd Scientific Sessions on June 9th and published Online First in The Lancet.

The researchers examined data from the Diabetes Prevention Program Outcomes Study (DPPOS), which analyzes long-term outcomes in patients who participated in the Diabetes Prevention Program (DPP). The DPP involved more than 3,000 individuals with pre-diabetes who were at high risk of developing Type 2 diabetes.

Earlier examinations of the DPPOS and DPP data have demonstrated that drug treatment and lifestyle interventions can reduce the risk of people with pre-diabetes developing diabetes. However, in this study, the team set out to examine patients who not only did not develop diabetes, but actually reverted to normal glucose function at some point during the study period.

The team found that these patients were 56% less likely to develop diabetes during the 5 to 7 year follow-up period, regardless of how the reversion was achieved and even when it was only temporary. According to the researchers, these findings may be vital for planning diabetes reduction strategies.

Lead author Dr Leigh Perreault of the University of Colorado, USA, explained:

"Results from the present analysis would contend that the strategy is unimportant as long as the intervention is early (when someone has preddiabetes) and can restore normal glucose regulation, even if transiently... This analysis draws attention to the significant long-term reduction in diabetes risk when someone with prediabetes returns to normal glucose regulation, supporting a shift in the standard of care to early and aggressive glucose-lowering treatment in patients at higher risk."

In an associated comment, Dr Natalia Yakubovich of McMaster University, Canada, said: "Identification of regression to normal glucose regulation could be an important way to stratify people into those at higher and lower risk of progression to diabetes. Such stratification could therefore identify individuals for whom additional treatment might be needed to prevent diabetes or to slow down disease progression."

Dr. Yakubovich continued:

"Factors that predict regression to normal glucose regulation, what makes this regression temporary or sustained, and whether regression reduces long-term outcomes are all questions that need further research. The results of such research might substantially change the therapeutic strategy from diabetes prevention and lifelong glucose lowering treatment to induction of regression and monitoring for relapse."

Written By Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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