Various medications have been touted as a way to reduce the risk of type 2 diabetes. But are drugs really the silver bullet for diabetes prevention?
Who's at risk of type 2 diabetes ?
Being overweight is one of the main risk factors for type 2 diabetes. Inactivity is a concern, too. The less active you are, the greater your risk of type 2 diabetes. The risk also increases as you get older — especially after age 45.
Can medication help prevent type 2 diabetes ?
For some people, medication is part of an overall plan for diabetes prevention. Drugs commonly used to treat diabetes - such as metformin (Glucophage) and rosiglitazone (Avandia) - can also help prevent diabetes in people at risk of the disease.
How well do these medications work ?
In one study of more than 5,000 people at high risk of developing diabetes, participants took either the medication Avandia or a placebo. After three years, diabetes occurred in 62 percent fewer people taking Avandia than taking a placebo.
In another study, participants taking the drug Glucophage also reduced their risk of developing diabetes — although by less striking percentages.
Is medication the obvious choice for anyone at risk of diabetes ?
The makers of Avandia can make powerful claims about the effectiveness of the drug for diabetes prevention. But that's only part of the story.
Side effects of Avandia may include headache, back pain and fluid retention. Some people taking Avandia gain weight, which only fuels the risk of diabetes. In a few people, Avandia may contribute to swelling in the back of the eye and life-threatening liver failure or heart failure. An increased risk of heart attack may be a concern as well, especially for people who have heart disease or other risk factors for a heart attack.
Of course, there's also an expense involved. And some people argue that prescribing preventive medication is simply treating diabetes earlier in the course of the disease.
So what's the key to diabetes prevention ?
Healthy lifestyle changes remain the most effective — and safest — way to truly prevent disease. It's not easy, but you can do it.
To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Choose healthy foods low in fat and calories, including plenty of fruits, vegetables and whole grains. Eat smaller portions. Increase your physical activity, even if it's just parking farther from the door or taking the stairs instead of the elevator. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
And even if you don't lose weight, physical activity still lowers your blood sugar and boosts your sensitivity to insulin — which helps keep your blood sugar within a normal range.
How well do lifestyle changes work ?
You might be surprised. In a trial sponsored by the National Institutes of Health, participants who aimed to lose 7 percent of their body weight and exercised 30 minutes a day were nearly 60 percent less likely to develop diabetes than were people who maintained poor eating or exercise habits. Lifestyle changes worked particularly well for participants age 60 and older, who reduced their risk of developing diabetes by more than 70 percent.
Better yet, there's no risk of side effects and no medication expense. And as long as you continue to exercise and eat healthy foods, you'll enjoy the benefits of better health.
If you can commit to a healthier lifestyle — even if it's simply a daily stroll or a healthier afternoon snack - diabetes prevention may become a way of life.
By : Maria Collazo-Clavell, M.D.
