Prevention of diabetes: Lifestyle and metformin are the way forward

doi:10.1136/bmj.333.7574.918-d

BMJ 2006;333:918-919 (28 October), doi:10.1136/bmj.333.7574.918-d

Letter

Prevention of diabetes

Lifestyle and metformin are the way forward

The first 150 words of the full text of this article appear below.

EDITOR—The concern expressed by Heneghan et al¹ that drugtreatment to prevent diabetes may not be as attractive as itfirst seems, may be justified for rosiglitazone but is not formetformin, which is effective, safe, and cheap.

While the 31% reduction in new cases of diabetes with metforminin the Diabetes Prevention Program (DPP)² seems unimpressivecompared with the lifestyle groups' 58%, in certain subgroupsmetformin was more impressive. Reduction of incidence of diabetesin the young (under 45) was 44% and in the obese (BMI > 35)53% (lifestyle 48% and 51%, respectively). It would be interestingto see an analysis of the "young and obese."

Moreover, subjects in the programme were highly selected tobe appropriate for a trial of intensive lifestyle modification.For example, smoking prevalence was only 7%. We are unlikelyto see the same gains from lifestyle intervention in the realworld.

. . . [Full text of this article]

John S Ashcroft, general practitioner

Old Station Surgery, Ilkeston, Derbyshire DE7 8ES john.ashcroft@nhs.net