After allegations were made linking the diabetes drug rosiglitazone (Avandia) to an increased risk of heart attack, it was taken off the market in Europe, and its use was severely restricted here by the FDA. Now a new study in the New England Journal of Medicine gives hope that a related “glitazone” drug, pioglitazone (Actos), may actually be able to stave off diabetes. Both drugs came on the market in 1999.
In a randomized, double-blind, placebo-controlled study of 602 patients who had elevated blood sugar levels (“pre-diabetes”) but had not yet progressed to diabetes, researchers from the University of Texas Health Science Center in San Antonio found that the annual average incidence of progression to Type II diabetes was 7.6 percent for patients in the placebo group and 2.1 percent for patients taking pioglitazone daily over the course of about two years. That translates to a 72 percent reduction in the risk of diabetes.
Other benefits noted in the pioglitazone group included a lower diastolic blood pressure and improved lipid levels. Side effects associated with the drug included weight gain (average 3.9 kilograms) and fluid retention. Some, including Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, criticized the study results, suggesting it’s not obvious whether the drug actually prevented diabetes or just lowered elevated blood sugar levels. Other experts, including Dr. Ralph A. DeFronzo, chief of the diabetes division at the health science center and senior author of the study, said the findings were “astounding.”
“What Dr. Nissen is essentially trying to say is that keeping blood sugar under control with this drug is important, but the question remains whether people taking the drug, even those who aren’t diagnosed with diabetes, will actually have better health outcomes in the diabetes target organs — the heart, brain, eyes, and kidneys — over the next decade,” says ACSH's Dr. Gilbert Ross.