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Can Diabetes Be Prevented?

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In this study, 188 participants at high risk for type 2 diabetes were randomly chosen to receive either reinforced lifestyle advice or basic advice on healthy living. At the same time, the participants were assigned to groups that either received the diabetes medication gliclazide daily, a placebo "dummy" pill, or no tablets at all.

At the end of the six-year study, the participants receiving reinforced advice had lost somewhat more weight than the those getting basic advice, and they had less fat in their diets. However, the groups' rates of progression to diabetes were similar. The medication group, placebo group, and no-tablet group also had similar rates of progression.

The difference between the studies is probably because the Finnish study involved more structure and support, while the British study focused on supportive advice, Holman tells WebMD.

The problem with lifestyle changes is putting them into practice in a real-life situation, says Holman, professor of diabetic medicine at the University of Oxford in Cambridge, England. "The achievable ... changes in people leading routine lives are not large enough to reduce the risk of diabetes," he says. "Only greater changes will have this effect."

Insulin injections may prevent type 1 diabetes in people at risk of developing it, says Tihamor Orban, MD. He and colleagues at the Joslin Diabetes Center in Boston have followed 31 participants who have a parent or a brother or sister with type 1 diabetes as well as the blood antibodies for diabetes. They shared their findings at the ongoing ADA conference.

The investigators report that daily injections of a small amount of insulin under the skin helped slow down the onset of diabetes in the people they looked at; by the end of the study, 83% were free of disease. However, all of the people in the group that got no injections developed diabetes.

These findings give good evidence that such injections of insulin can either delay, or maybe even prevent, diabetes in people at risk of getting it, Orban, an instructor in medicine at Harvard Medical School.

"We don't know yet, though, if these people will require lifelong injections of insulin," he points out. Future studies may involve stopping the daily insulin shots to see if the treatment has lasting benefits.

 

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