Following the Avandia scandal in July 2010, the European Medicines Agency (EMA) on 23 Sept recommended the suspension of the rosiglitazone-containing anti-diabetes medicines Avandia, Avandamet and Avaglim, they will be banned in Europe within the next few months. At the same time, the US government put toughened resrictions on the use of the drug. Critics say these "decisions will virtually eliminate use of the drug around the world".
According to a new study published in the Archives of Internal Medicine, 27 September, lifestyle interventions are recommended to improve glycemic control and risk factors in type 2 diabetes to prevent long-term complications, but the evidence of their efficacy is limited to short-term studies.
The authors said that the Look AHEAD study, a 4-year non-drug approach using intensive lifestyle interventions helped reduce cardiovascular risk factors in type 2 diabetics. The trial randomized 5145 patients with type 2 diabetes to following an intensive lifestyle- intervention program or to receive standard diabetes support and education. The intensive program including a combination of diet modification and physical exercises, with training and group support, was designed to achieve 7% weight loss in the first year and to maintain the weight in subsequent years.
After 4 years, the intensive intervention group maintained a weight loss of 6.15% of their weight compared with 0.88 % in the standard support group. They also experienced greater improvements in fitness, blood sugar, blood pressure, triglycerides and good cholesterol. The standard group had lower levels of bad cholesterol.
The authors said that the result indicated that the intensive intervention group had been exposed to lower cardiovascular disease risk factors during the trial, although it would be too early to say that intensive intervention can prevent heart attacks, there may be long-term benefits from the 4-year period. The study is continuing for several more years.
Should we look beyond Avandia and other drugs for diabetes treatment and invest in more preventive efforts?
Source: Long-term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals With Type 2 Diabetes Mellitus - Four-Year Results of the Look AHEAD Trial. The Look AHEAD Research Group. Arch Intern Med. 2010;170(17):1566-1575. (f/t via Athens)
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