Preventing type 2 diabetes with low-dose combinations.

摘要

The past decade has seen major advances in clinical trial evidence to support improved care in diabetes. One important area is prevention of type 2 diabetes. Several trials have tested single interventions for their ability to reduce the incidence of diabetes in high-risk individuals. Lifestyle interventions aimed at reducing bodyweight, and use of metformin, thiazolidinediones, acarbose, and orlistat, reduce the risk of diabetes by 25-60% over 3-6 years. General lly, interventions aimed at reducing body fat or its adverse metabolic effects show the best evidence for slowing or stopping progression to diabetes. Indeed, the insulin secretagogue, nateglinide, had no effect in reducing diabetes risk. Despite the positive outcomes of these trials, it remains unclear whether prevention is superior to early treatment in terms of long-term health.