Avandia as a Type 2 Prevention Tool?
A drug that can slash the risk of developing type 2 diabetes by over sixty percent? That's the hot story out of Copenhagen, where the European Association for the Study of Diabetes held its annual meeting last week, and it could be the biggest news in diabetes prevention since the DPP trial findings were announced in 2002. But is rosiglitazone maleate (Avandia) the magic bullet for a global health crisis, or an expensive band-aid that gives us yet another reason not to invest in the healthy lifestyle changes that are known to slash type 2 diabetes risk by up to 70 percent?
The DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) trial followed 5,269 people with pre-diabetes over three years to determine their likelihood of developing type 2 diabetes. Those who took Avandia (rosiglitazone maleate) reduced their risk of developing type 2 diabetes by 62 percent, compared to those who took a placebo. All study subjects were also counseled on healthy eating and exercise.
The DREAM results have been met with skepticism and caution by some in the diabetes community, who cite heart risks, expense, and lack of long-term data on Avandia as factors that may preclude the drug from widespread use as a preventative. And there is also some concern that media attention to the study could send the wrong message - that a pill is a substitute for healthy lifestyle changes. What we do know for certain is that diet and exercise remain the most effective tool we have for type 2 diabetes prevention. And while the Avandia results are impressive, they don't address the underlying problems of how to motivate behavioral and social changes to combat the inactivity and poor nutrition that are fueling the type 2 diabetes crisis.
Comments
- At 07:48 PM on Sun, Oct 1, 2006 Tabbie wrote:
I have been on Avandia for more than a year now. It has been such a blessing to me, it has been the only med that had helped me get my Type 2 Diabetes down to where I can control it.
The DREAM study comes as no surprise to me. I have been on TZDs for seven years, five years on Avandia. The key is that I exercise and that makes Avandia work alot better plus exercise negates Avandia's side-effects of water rretention and weight gain. Before going to Resulin/Avandia I was on several medications that worked great for short times (usually had to up medication within a year). Exercise and diet did not work, but with Avandia they work great!
One of the basic ways that I view Avandia is that helps muscles get the glucose they need but don't get because of insulin resistance. This glucose transfer to the cells allows me to exercise longer, harder, and recover quicker than I did before Avandia. Because I view Avandia as helping to reverse the pathology behind my type-2 diabetes, I don't consider it a cruch any more than an antibotic is a cruch.
Because Avandia helps build muscle strength, it is good for the heart and eventually it will be proven that exercise and Avandia are a very good combination to prevent or delay CVD. There has already been a study that shows the positive effects Avandia has on the heart (A Korean study showed that Retinosis was reduced after stint insertion in a heart artery when the patient was on Avandia).
Chuck