Prevention of diabetes in cardiovascular studies: implications for the aetiology of type 2 diabetes

Abstract

Recent studies have shown the importance of lifestyle measures in preventing or delaying the development of type 2 diabetes in people with impaired glucose tolerance (IGT). Lifestyle measures appear to be more beneficial than therapy with metformin, or acarbose, and the benefit is most likely to be mediated by reductions in insulin resistance. Several large, multi-centre cardiovascular studies have also been performed where the development of new diabetes has been a secondary end point, and some ACE inhibitors, angiotensin receptor antagonists, and statins also appear to prevent or delay the development of diabetes in at-risk patients. These may act by increasing insulin sensitivity, decreasing inflammatory markers, or by affecting other key components of the metabolic syndrome. This is being tested in ongoing studies in patients with IGT.