Drug 'Avandia' May Prevent Diabetes
Study Shows Drug Cut Diabetes Risk by 60%
Avandia: Not All Good News
Not all the news from the Avandia trial was good, however. Fourteen of the
people treated with the drug developed heart failure (0.5%), compared with just
two people (0.1%) in the placebo arm of the study.
"Balancing both benefits and risks suggests that for every 1,000 people
treated with [Avandia] for three years, about 144 cases of diabeteswill
be prevented, with an excess of four to five cases of congestive heart
failure," the researchers wrote in The Lancet.
American Diabetes Association president Larry C. Deeb, MD, tells WebMD that
the finding means that the drug is not appropriate for all people at high risk
"This probably isn't the drug to use in patients who have multiple risk
factors for heart failure, and anyone with any risk factors should be monitored
closely while they are on it," he says.
Deeb points out that the reduction in diabetes risk reported by Gerstein and
colleagues is almost identical to that seen with modest changes in lifestyle in
a major, U.S. government-funded prevention trial.
People who took part in the Diabetes Prevention Program trial were asked to
eat less fat and fewer calories and to exercise for 30 minutes a day five days
a week. These lifestyle changes resulted in a 58% reduction in risk for getting
type 2 diabetes.
"These people weren't asked to drop huge amounts of weight or run 5
miles a day, seven days a week," Deeb says. "They were asked to make
modest lifestyle changes, but the risk reductions were dramatic."
While the participants in the Avandia study were also instructed on diet and
exercise, it is not clear how many of them changed their eating and exercise
"It is reasonable to think that combining this drug with lifestyle
change could result in even greater reductions in diabetes risk, but we can't
say this from this study," Deeb says.
In the same government trial, taking the drug metformin (Glucophage), which
is already widely used for diabetes prevention, was associated with a 31%
reduction in disease risk -- about half that seen in the Avandia study.