;

Pharmacy Product - Diabetes - Types of Diabetes - Diabetes Prevention Program

Diabetes

Diabetes Prevention Program

* DPP Study Design and Goals
* Type 2 Diabetes and Pre-diabetes
* Who should be tested for pre-diabetes and diabetes?
* DPP Results
* Further Analyses of DPP Data
* Points to Remember
* Hope through Research
* For More Information

The Diabetes Prevention Program (DPP) was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in study participants. At the beginning of the DPP, participants were all overweight and had blood glucose, also called blood sugar, levels higher than normal but not high enough for a diagnosis of diabetes—a condition called pre-diabetes.

The DPP found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes. Taking metformin also reduced risk, although less dramatically. The DPP resolved its research questions earlier than projected and, following the recommendation of an external monitoring board, the study was halted a year early. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine.


DPP Study Design and Goals
In the DPP, participants from 27 clinical centers around the United States were randomly divided into different treatment groups. The first group, called the lifestyle intervention group, received intensive training in diet, physical activity, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7 percent of their body weight and maintain that loss.

The second group took 850 mg of metformin twice a day. The third group received placebo pills instead of metformin. The metformin and placebo groups also received information about diet and exercise but no intensive motivational counseling. A fourth group was treated with the drug troglitazone (Rezulin), but this part of the study was discontinued after researchers discovered that troglitazone can cause serious liver damage. The participants in this group were followed but not included as one of the intervention groups.

All 3,234 study participants were overweight and had pre-diabetes, which are well-known risk factors for the development of type 2 diabetes. In addition, 45 percent of the participants were from minority groups—African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander—at increased risk of developing diabetes.


Type 2 Diabetes and Pre-diabetes
Type 2 diabetes is a disorder that affects the way the body uses digested food for growth and energy. Normally, the food one eats is broken down into glucose, a form of sugar. The glucose then passes into the bloodstream, where it is used by the cells for growth and energy. For glucose to reach the cells, however, insulin must be present. Insulin is a hormone produced by the pancreas, a fist-sized gland behind the stomach.

Most people with type 2 diabetes have two problems: insulin resistance a condition in which muscle, liver, and fat cells do not use insulin properly and reduced insulin production by the pancreas. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body, never fulfilling its role as the body’s main source of fuel.

About 23.6 million people in the United States have diabetes. Of those, 17.9 million are diagnosed and 5.7 million are undiagnosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness in American adults. People with diabetes are more likely than people without diabetes to develop and die from diseases of the heart and blood vessels, called cardiovascular disease. Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes, and the risk for stroke is two to four times higher among people with diabetes.

Pre-diabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Pre-diabetes is also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on the test used to measure blood glucose levels. Having pre-diabetes puts one at higher risk for developing type 2 diabetes. People with pre-diabetes are also at increased risk for developing cardiovascular disease.

Pre-diabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—had pre-diabetes in 2007. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes.


Who should be tested for pre-diabetes and diabetes?
The American Diabetes Association recommends that testing to detect pre-diabetes and type 2 diabetes be considered in adults without symptoms who are overweight or obese and have one or more additional risk factors for diabetes. In those without these risk factors, testing should begin at age 45.

Risk factors for pre-diabetes and diabetes—in addition to being overweight or obese or being age 45 or older—include the following:

 

* being physically inactive
* having a parent, brother, or sister with diabetes
* having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander
* giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes—diabetes first found during pregnancy
* having high blood pressure—140/90 mmHg or above—or being treated for high blood pressure
* having HDL, or “good,” cholesterol below 35 mg/dL, or a triglyceride level above 250 mg/dL
* having polycystic ovary syndrome, also called PCOS
* having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on previous testing
* having other conditions associated with insulin resistance, such as severe obesity or a condition called acanthosis nigricans, characterized by a dark, velvety rash around the neck or armpits
* having a history of cardiovascular disease

If results of testing are normal, testing should be repeated at least every 3 years. Doctors may recommend more frequent testing depending on initial results and risk status.

 

 

 
Pharmacy Products |  History |  Drugs Generic Names |  Drugs Brand Names | Medical Information |  Link Exchange |  Links | Contact us |  Sitemap | Pharmacy Products News |  Pharmaceutical Companies |  Cancer Fighting Foods
Custom Silicone Bracelets | We Buy Houses, Stop Foreclosure | Ice Cream Park | Car Shipping