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Aggressive Pre-Diabetes Treatment cuts Diabetes Risk

New research found that an early and aggressive approach is an effective way to prevent and halt the chances of developing type 2 diabetes. The new study implies that those in the pre-diabetic phase who achieved a return to normal glucose levels, whether temporary or permanent, were less likely to develop type 2 diabetes 5.7 years later.

“This analysis draws attention to the significant long-term reduction in diabetes risk when someone with pre-diabetes returns to normal glucose regulation, supporting a shift in the standard of care to early and aggressive glucose-lowering treatment in patients at highest risk,” said lead author Dr Leigh Perreault of the University of Colorado Anschutz Medical Campus.
Pre-diabetes is considered a “high risk state” for type 2 diabetes where blood glucose levels are higher than normal, but not as high as in diabetes.

In the United States, it is estimated by the Centers for Disease Control and Prevention (CDC) that 79 million Americans, over one third of their adult population, have pre-diabetes. With that, about one in ten pre-diabetics develop full-blown diabetes.

In this analysis, the patients were assigned to one of three groups: 736 to receive intensive lifestyle intervention, 647 to the diabetes drug metformin, and 607 to placebo.

Unlike previous findings where the focus is only on the finding that lifestyle and medication can reduce the chances of developing full-blown diabetes, this latest research also looked at those patients who not only did not progress to diabetes, but whose glucose levels actually returned to normal at some point during the period they were being followed.

Findings show that patients had 56 percent reduction in diabetes progression during 5.7 years of follow-up, regardless of what caused the return to normal glucose levels.

However, those who had intensive lifestyle intervention but glucose levels was not able to return to normal were found to be the ones most likely to develop diabetes.

“Reversion to normal glucose regulation, even if transient, is associated with a significantly reduced risk of future diabetes independent of previous treatment group,” concluded the study. Dr. Natalia Yakubovich of McMaster University in Canada and was not involved in the study, believes that these findings are not enough on their own and more work is needed to cause a revision in diabetes prevention strategies.

“Factors that predict regression to normal glucose regulation, what makes this regression temporary or sustained, and whether regression reduces long-term outcomes are all questions that need further research,” added Dr. Yakubovich.

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