Drug Prevents Type 2 Diabetes in Majority of High-Risk Individuals; Pennington Biomedical Research Center Participates in Key Research Study

Staff reports

Researchers have discovered that a pill taken daily prevents type

2 diabetes in more than 70 percent of individuals whose obesity, ethnicity and other

markers put them at highest risk for the disease, according to the New England Journal

of Medicine.

The drug, called pioglitazone, is widely used as an insulin sensitizer in patients

with type 2 diabetes. In the ACT Now research study, participants were chosen because

of their high risk for diabetes, including obesity, family history and impaired

glucose tolerance.

Forty million Americans are at risk of developing diabetes, which is often coupled

with serious consequences such as cardiovascular disease and stroke. This at-risk

condition is referred to as pre-diabetes and researchers are looking for ways to

delay or reduce the risk of diabetes.

The study, published March 25 in the New England Journal of Medicine (NEJM), conducted

in-part at the Pennington Biomedical Research Center, reported that the drug pioglitazone,

currently marketed as Actos® for the treatment of diabetes, actually reduced the

risk of developing diabetes by 72 percent. "We tested pioglitazone in at-risk individuals

for 2 years to see whether, compared to a placebo, it would reduce the conversion

to diabetes. It did indeed," said co-author George Bray, M.D., Boyd Professor at

the Pennington Biomedical Research Center in Baton Rouge, Louisiana.

"It's a blockbuster study," said senior author Ralph DeFronzo, M.D, professor in

the School of Medicine and chief of the diabetes division a the University of Texas

Health Science Center San Antonio. "The 72 percent reduction is the largest decrease

in the conversion rate of pre-diabetes to diabetes that has ever been demonstrated

by an intervention, be it diet, exercise or medication." ACT Now was funded by an

independent investigator grant provided by Takeda Pharmaceutical Co. Ltd., the marketers

of Actos®. 602 participants were enrolled through the Pennington Biomedical Research

Center, lead site UT Health Sciences Center San Antonio, and six collaborating centers

across the United States. Pioglitazone, used as an insulin sensitizer in patients

with type 2 diabetes, was given to 303 participants, with the remaining 299 receiving

a placebo. The trial spanned 4 years, the average follow up was 2.4 years.

In addition, use of pioglitazone improved diastolic blood pressure, HDL cholesterol

levels, and serum levels. It also slowed the progression of carotid artery thickening,

a damaging condition associated with heart disease and strokes.  "This study represents

Pennington's overarching goal of preventing the onset of debilitating chronic diseases,

including type 2 diabetes," said Steven Heymsfield, M.D., executive director of

the Pennington Biomedical Research Center. Pennington's research seeks to uncover

the triggers of chronic diseases - like diabetes and heart disease - to find comprehensive,

prevention-based solutions that offer hope to more people.