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Diabetes Drug Actos May Also Help Prediabetes

Study Shows Actos Lowers Risk of Developing Diabetes in People With Prediabetes
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Lifestyle Changes vs. Drug Treatment continued...

Half the study participants were randomly assigned to be treated with Actos; the other half got a placebo. The patients were followed for an average of 2.4 years.

Over the course of the study, the yearly progression to diabetes was 2% in the Actos-treated patients and 7.6% in the placebo group.

About half the patients who took the insulin-sensitizing drug (48%) saw their blood sugar levels return to normal during treatment, compared to just over one-fourth (28%) of the placebo-treated patients.

Actos-treated patients also had reductions in diastolic blood pressure and increases in HDL “good” cholesterol. Treatment with the diabetes drug was also associated with a 31% decrease in the rate of carotid artery thickening.

But the active treatment was also associated with significantly greater weight gain (8 and 1/2 pounds compared to 1 and 1/2 pounds). And fluid retention was twice as common in the Actos patients (13% vs. 6.4%).

Funding for the study was provided by Actos manufacturer Takeda Pharmaceuticals.

Weighing Risks vs. Benefits

Study co-researcher Robert R. Henry, MD, says the findings show that targeting insulin sensitivity can have a dramatic impact on diabetes risk.

The treatment-related reduction in diabetes risk was higher than that associated with healthy changes in lifestyle in a diabetes prevention study from the National Institutes of Health.

But Henry says lifestyle intervention will remain the recommended treatment for most of his patients with prediabetes. Henry is chief of endocrinology and diabetes at the VA San Diego Healthcare System and the president of medicine and science with the American Diabetes Association.

“I might consider pioglitazone in patients who have a very high diabetes risk, but this would be a very restricted population,” he says. “As with all drug treatments, the risks and benefits have to be weighed.”

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