A new study shows that people who are high risk of developing Type 2 diabetes may be able to prevent the disease by taking pioglitazone (sold as Actos), a common drug for diabetes treatment. But experts say that doesn’t mean everyone with high blood sugar levels should be taking the medication.

Diabetes often progresses from a condition of impaired insulin sensitivity to the full-blown disease. Doctors have long been eager to find medications or lifestyle changes that can slow this progression or stop it altogether. While 21 million Americans suffer from Type 2 diabetes, nearly four times as many have high blood sugar levels that put them at risk of developing the disease.

Now researchers led by Dr. Ralph DeFronzo at the Texas Diabetes Institute and University of Texas Health Science Center report in the New England Journal of Medicine that pioglitazone can be an effective tool in helping high-risk patients control their blood sugar and stop the onset of diabetes.

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Many don’t know they have the condition, experts say, adding that they’ll advance to Type 2 diabetes if they don’t exercise moderately and improve their diet.

March 21, 2011

Diabetes doesn’t pounce on a person out of the blue. Before the diagnosis, a person may linger on the fringes of the condition — blood sugar high but not yet over that line that is clearly diabetes — for years. The U.S. Centers for Disease Control and Prevention released figures in January showing that the number of American adults with prediabetes had jumped from 57 million in 2008 to 79 million in 2010. During the same period, the number with full-on diabetes grew from 23.6 million to 26 million, the vast majority of which are Type 2 cases.

These numbers are somewhat inflated by the use of a new test, hemoglobin A1c, that can detect cases of prediabetes or diabetes that older tests might have missed. Still, experts have no doubt that prediabetes really is on the rise. “Many people have it and don’t know it,” says Dr. Kevin Kaiserman, a pediatric endocrinologist in private practice and president of the American Diabetes Assn, Los Angeles.

Just like people with Type 2 diabetes, those with prediabetes have high blood sugar levels because their body has become less responsive to insulin, the hormone that keeps blood sugar levels in check, or doesn’t produce enough of it. But having prediabetes is not necessarily a guarantee that a person will get Type 2 diabetes. Improved nutrition and increased physical activity can help stave off the condition.

“Lifestyle changes can absolutely reverse the course,” Kaiserman says.

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