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Magic Pill Prevents Diabetes!

Posted Mar 24 2011 5:13pm
I read about magic, breakthru pills on the Internet everyday.  Marketing ploys tout all natural, 100% organic, dietary supplements, as if natural & organic equal safe.  Think about this.  Would you wipe your ass w/poison oak or poison ivy?  No?  But it's natural!  Would you snort a line of cocaine, inject some heroin or smoke some marijuana just because no antibiotics & fertilizers were used in their production?  Thought not.  Well, most of you, anyway!

Diabetes, especially the common Type 2 version associated w/being overweight & obese, is becoming a real big problem, pun intended.  We've known how to fix this (prevent diabetes) at least since 2002 - stop stuffing our faces & get off our butts .  However, that's easier said than done.  Most of us are still waiting for that magic pill that will cure everything w/o causing any side effects.

Back in 2002, the Diabetes Prevention Program (DPP) concluded in a randomized study over close to 3 years that lifestyle modification reduced one's risk of developing diabetes by 58% while taking the medicine, metformin, reduced one's risk by 31%, compared to doing neither.  Statistically speaking, these two interventions were considered equivalent.  But I suspect that due to a history of concern over the risk of lactic acidosis as well as its known GI side effects, metformin never gained traction, although some physicians do prescribe it in just such a fashion.

As as you know, inertia trumps lifestyle modification hands down.  Over the next 10 years of follow up after conclusion of the randomized portion of DPP, as published in the Lancet , the total risk of developing diabetes was still lower in those who changed their lifestyle.

Well, for those of you waiting for that magic pill, I'm happy to report that a study published today in the New England Journal of Medicine concluded that pioglitazone reduced the risk of becoming diabetic in a randomized, double-blind, placebo-controlled 2.4 year study 602 patients w/impaired glucose tolerance.  Those who received pioglitazone noted statistically significant lower fasting glucose, HgbA1c (running 3 month average of sugar control), diastolic blood pressure (bottom number), and rate of carotid intima-media thickening (less is good), as well as higher HDL cholesterol (the good kind).

Down sides?  You should monitor your liver function while taking this drug.  And those taking pioglitazone were more likely to suffer from weight gain and edema (fluid retention), both well known side effects.  This particular study was too small & too short to shed any light on the recent revelation of increased risk of fractures & heart failure in those taking pioglitazone.

What about taking both?  After all, we've been treating diabetics with this 1-2 punch for years and there's even a combination pill available, Actoplus Met .  So if you're really not inclined to change your lifestyle and just want to pop a pill to prevent diabetes, I suppose you could have your cake and eat it, too.  Just be sure you don't already have kidney disease and heart failure - and as always, talk it over w/your family physician about whether it's worth the risk or not.  But if you want a risk free solution, stop stuffing your face and get off your ass!  By the way, this study was sponsored by the manufacturers of pioglitazone . . .

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