Treating early signs of diabetes risk may stave off the disease

November 8, 2018   /

By Lisa Rapaport

(Reuters Health) - People with slightly elevated blood sugar and other early signs of risk for type 2 diabetes may avoid developing the full-blown disease if they start taking medications or make lifestyle changes that are usually used to treat diabetes, researchers say.

The study team examined data on 422 adults in southern California with slightly elevated blood sugar and an intermediate or high risk for developing diabetes based on insulin resistance, beta cell function, and glucose tolerance tests. All of the patients were told to make lifestyle changes like modifying their diet and exercise habits; 141 people were also asked to take two types of diabetes drugs, and 81 patients were asked to take three types of diabetes drugs.

After an average follow-up period of almost three years, the annual rate of transitioning to full diabetes was 4.1% among people who received only lifestyle therapy, and 1.7% in patients on two diabetes drugs, the study found. None of the patients on three diabetes drugs developed diabetes.

"Our study demonstrates that a personalized preventive strategy based upon physiology combining lifestyle modification and targeted medications can be extremely effective in preventing progression to diabetes," said lead study author Dr. John Armato of the Providence Little Company of Mary Cardiometabolic Center in Torrance, California.

"It is always recommended that patients embrace regular exercise, targeted weight loss, limitation of alcohol intake and getting adequate sleep because, if implemented consistently and maintained, this may be all that is needed to restore ideal health," Armato said by email.

The study findings also suggest that some patients may want to consider the targeted use of medications in addition to lifestyle changes, Armato added.

About one in three U.S. adults have slightly elevated blood sugar that is sometimes called "prediabetes" even though it's not high enough to warrant a diabetes diagnosis, researchers note in The Lancet Diabetes & Endocrinology. Roughly one in three of these people will progress to full-blown diabetes within five to seven years, they write.

All of the patients in the study who were prescribed two medications were given metformin and pioglitazone.

People taking three medications were given metformin and pioglitazone as well as a newer injected diabetes drug in a family of medicines that includes exenatide and liraglutide.

Compared to people who only received lifestyle therapy, patients who took metformin and pioglitazone were 71% less likely to develop diabetes, the study found.

Patients who took both of those drugs as well as medicines like exenatide or liraglutide were 92% less likely to develop diabetes than those who only received lifestyle therapy.

One limitation of the study is that people who were given only lifestyle therapy received this treatment because they refused to take medications, so the treatment groups were not random, which might influence the results, the authors note.

It's also not clear from the study whether medications may have prevented diabetes from developing or helped to manage symptoms in people who did develop diabetes, they add.

Still, the results add to evidence suggesting that some people without full-blown diabetes may benefit