Pharmaceutical Interventions for Diabetes Prevention in Patients at Risk
journal contributionposted on 2020-04-21, 08:32 authored by Sudesna Chatterjee, Melanie Davies, Kamlesh Khunti
With the rising incidence and prevalence rates of type 2 diabetes globally, it is imperative that diabetes prevention strategies are implemented to stem the flow of new cases. Successful interventions include both lifestyle modification and pharmaceutical agents, and large, multicentre, randomised, controlled studies in different populations have identified the benefits of both. However, translating positive trial outcomes to the real world is particularly challenging, as lifestyle interventions require regular reinforcement from healthcare professionals to be maintained. Pharmaceutical therapies may therefore play an adjunctive role in combination with lifestyle to prevent diabetes. Population-based strategies are also necessary to reduce sedentary behaviour and obesity. Well-established glucose-lowering therapies such as metformin, sulphonylureas, thiazolidinediones and insulin and newer agents such as incretin therapies and sodium glucose co-transporter 2 inhibitors have all been investigated in randomised controlled trials for diabetes prevention with varying success. Non-glucose-lowering therapies such as orlistat and renin angiotensin system blockers can prevent diabetes, whereas statins are associated with slightly increased risk. Diabetes prevention strategies should carefully consider the use of these agents according to individual patient circumstances and phenotypic profile.
The authors acknowledge support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care—East Midlands (NIHR CLAHRC—EM), the Leicester Clinical Trials Unit, and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Centre, which is a partnership between the University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester.
CitationChatterjee, S., Davies, M. & Khunti, K. Pharmaceutical Interventions for Diabetes Prevention in Patients at Risk. Am J Cardiovasc Drugs 18, 13–24 (2018). https://doi.org/10.1007/s40256-017-0239-y
- AM (Accepted Manuscript)
Published inAMERICAN JOURNAL OF CARDIOVASCULAR DRUGS
Pagination13 - 24 (12)
PublisherADIS INT LTD
Science & TechnologyLife Sciences & BiomedicineCardiac & Cardiovascular SystemsPharmacology & PharmacyCardiovascular System & CardiologyIMPAIRED GLUCOSE-TOLERANCEBETA-CELL FUNCTIONCONVERTING-ENZYME-INHIBITORSRANDOMIZED CONTROLLED-TRIALLIFE-STYLE INTERVENTIONCARDIOVASCULAR EVENTSCARDIOMETABOLIC RISKCOST-EFFECTIVENESSWEIGHT MANAGEMENTFASTING GLUCOSE