A once or twice daily pill that makes the body more sensitive to insulin can help prevent type 2 diabetes, scientists said yesterday, potentially helping to stem the soaring numbers of people with the disease caused by the obesity epidemic.
At the end of a three-year trial, an international team of researchers announced that giving people at high risk a pill called rosiglitazone, marketed under the brand name Avandia by the British company GlaxoSmithKline, along with advice on diet and exercise, can prevent two-thirds of them developing diabetes.
People with diabetes have too much glucose (sugar) in their blood because the pancreas is not making enough insulin - a natural hormone - to process it properly. Rosiglitazone is currently used to treat people with type 2 diabetes. It is called an "insulin sensitiser" because it causes the body's cells to become more responsive to insulin, so that they remove more glucose from the blood.
Canadian investigators said in a paper published online by the Lancet yesterday that a three-year trial aimed at preventing diabetes had shown a substantial reduction in cases among those taking the tablets.
The trial recruited 5,269 adults at high risk of diabetes across 21 countries. They were randomly divided into two groups to receive either 8mg of rosiglitazone daily or inactive placebo pills. All patients received advice about diet and lifestyle. After three years, 280 individuals taking the drug and 658 on the placebo developed diabetes. A small risk of non-fatal heart failure was seen in the rosiglitazone group. Sixteen patients were affected.
The researchers, led by Hertzel Gerstein from the Population Research Institute in Hamilton, Ontario, said the data on them needed to be further analysed so that people at risk could be identified.
The authors say: "Balancing both benefits and risks suggests that for every 1,000 people treated with rosiglitazone for three years, about 144 cases of diabetes will be prevented, with an excess of four to five cases of congestive heart failure."
Dr Gerstein told the Guardian the pill would add to options available in the battle to combat obesity, but was not the answer on its own. "It is important for everyone to determine if they are at risk of type 2 diabetes. If they are, they should explore the list of ways to reduce that risk."
Diabetes UK said the results were interesting, "but it would be wrong to assume that we can solve the epidemic of Type 2 diabetes by taking a tablet".
Backstory
More than 65% of men and 55% of women in the UK are overweight or obese. Over the past 20 years this has led to a parallel rise in numbers of patients with type 2 diabetes, which is obesity-linked - unlike type 1, which is genetic. Most of the now more than 2m diagnosed cases of diabetes - 85-95% - are type 2. Once it was unknown in childhood, but it is now being seen in children as young as seven.
