Saturday, June 21, 2008

Diabetes Prevention

Here are 2 articles published in the New England Journal of Medicine showing the powerful effect of lifestyle modification towards preventing diabetes. Lifestyle modification had almost double the incidence reduction of diabetes over the most popular drug Metformin (which some sources report a side effect rate in 50% of patients - mainly diarrhea and GI upset).

The first article is called, "Reduction in the Incidence of Type 2 Diabetes with Lifestyle intervention or Metformin" (2002)

The authors are: William C. Knowler, M.D., Dr.P.H., Elizabeth Barrett-Connor, M.D., Sarah E. Fowler, Ph.D., Richard F. Hamman, M.D., Dr.P.H., John M. Lachin, Sc.D., Elizabeth A. Walker, D.N.Sc., and David M. Nathan, M.D.

**One thing of interest I noticed was that the fasting glucose was nearly identical between the lifestyle group and the pharmaceutical group (Figure 3). Yet, the lifestyle group had double the preventive effect. This highlights the idea that solely controlling a biomarker (blood glucose in this case) to what is considered a "healthy range" may not be entirely effective towards preventing a disease.

The second is called, "Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle Among Subjects with Impaired Glucose Tollerance." (2001)

The authors are: Jaakko Tuomilehto, M.D., Ph.D., Jaana Lindstrom, M.S., Johan G. Eriksson, M.D., Ph.D., Timo T. Valle, M.D., Helena Hamalainen, M.D., Ph.D., Pirjo Ilanne-Parikka, M.D., Sirkka Keinanen-Kiukaanniemi, M.D., Ph.D., Mauri Laakso, M.D., Anne Louheranta, M.S., Merja Rastas, M.S., Virpi Salminen, M.S., Sirkka Aunola, Ph.D., Zygimantas Cepaitis, Dipl.Eng., Vladislav Moltchanov, Ph.D., Martti Hakumaki, M.D., Ph.D., Marjo Mannelin, M.S., Vesa Martikkala, M.S., Jouko Sundvall, M.S., Matti Uusitupa, M.D., Ph.D.

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