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Trials That Matter: Rosiglitazone, Ramipril, and the Prevention of Type 2 Diabetes

David M. Nathan, MD; and Michael Berkwits, MSCE, Deputy Editor
[+] Article, Author, and Disclosure Information

From the Massachusetts General Hospital Diabetes Unit, Boston, MA 02114, and American College of Physicians, Philadelphia, PA 19106.

Potential Financial Conflicts of Interest: Honoraria: D.M. Nathan (GlaxoSmithKline).

Requests for Single Reprints: David M. Nathan, MD, Massachusetts General Hospital Diabetes Unit, 50 Staniford Street, 3rd Floor, S503, Boston, MA 02114; e-mail, dnathan@partners.org.

Current Author Addresses: Dr. Nathan: Massachusetts General Hospital Diabetes Unit, 50 Staniford Street, 3rd Floor, S503, Boston, MA 02114.

Dr. Berkwits: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.

Ann Intern Med. 2007;146(6):461-463. doi:10.7326/0003-4819-146-6-200703200-00015
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Despite the growing number of options for treating type 2 diabetes, clinicians wanting to prevent the disease in high-risk patients have few good choices. Lifestyle changes that lead to weight loss can prevent diabetes (12) but are difficult to adopt and maintain (3). Drugs used to treat diabetes are often expensive, and testing has only recently begun on their efficacy as primary preventive agents. Two large trials in 2002 showed that metformin (1) and acarbose (4) effectively prevent diabetes in participants with impaired glucose tolerance, but neither drug has been approved by the U.S. Food and Drug Administration (FDA) for prevention and their use has not become part of routine practice.

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