Thursday, April 19, 2012

Are there any medications I can take to help prevent diabetes?

Yes, there are a number of medications that will help to reduce the likelihood of a person developing type 2 diabetes, but not type 1 diabetes. These are shown in Table 2. None  are labeled  by the  Food  and  Drug Administration for this indication. Our  use of them is mainly confined to choosing a drug that will tend to slow progression to type 2 diabetes when the drug is needed for another condition. For example, when a patient at  risk for diabetes needs treatment for high blood pressure, one would consider using a drug that has been shown to slow  progression to diabetes in

 Table 2

Medication                                                        Approved Use

Rampiril                                                               Blood pressure
Losartan                                                              Blood pressure
Caryedilol                                                           Blood pressure
Metformin                                                           Type 2 Diabetes
Acarbose                                                            Type 2 Diabetes
Hydroxychoroquine                                             Rheumatoid arthritis, malaria
Vitamin D                                                            Vitamin supplementation
Aspirin                                                                Pain and inflammation
those  at  high  risk, as  opposed  to  one  that  might actually  accelerate it.  Early use  of  drugs  that  are approved to treat  type 2 diabetes in people at high risk of development of type 2 diabetes (mainly those with prediabetes—for definition see Question 9) has also been shown to prevent or delay the onset of the disease. Examples of this use are also shown in Table
2. Whether  this represents prevention of diabetes or pretreatment of diabetes is not conclusively known. To be  considered true prevention, the drug needs to modify the course and progression of the underlying factors leading to the  disease and not merely lower the blood sugar. This means the rate at which those at risk progress to diabetes should be  reduced in a sustained manner. It should be emphasized that  one must be very cautious in advocating the use of oral antidiabetic  drugs  in  this  manner.  The  FDA  and other authoritative bodies have not evaluated the ratio of risk to benefit sufficiently to recommend their use in prediabetes.

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