"It looks like diet and exercise are the mainstays of prevention," he said. "If people could lose a few pounds more and exercise more, there would be a lot less diabetes."
It's an old message, but one that is difficult to get across, said Califf, who noted that more than 35 percent of the people in the trial did go on to develop diabetes in just five years. "We need to keep looking for better treatments, but lifestyle modification is the best thing we have going," he said.
The people in the trial, which was done at 806 centers across 40 countries, had diagnosed cardiovascular disease, known risk factors such as obesity and impaired ability to metabolize sugar.
They were divided into groups -- some receiving Diovan, some getting Starlix, and some taking a placebo. All entered a lifestyle modification program aimed at reducing weight and dietary fat intake and increasing physical activity.
Over five years, 36 percent of those taking Starlix developed diabetes, compared to 34 percent of those taking a placebo. Diabetes developed in about a third of those taking Diovan, compared to about 37 percent of those taking a placebo. The rates of cardiovascular problems and deaths were similar in all groups.
"We must continue to develop new therapies while encouraging people to exercise and pay attention to what they eat," Dr. John McMurray, professor of cardiology at the University of Glasgow in Scotland and a member of the trial's executive board, said in a Duke University news release. "Losing at little as 5 percent of body weight has been shown to make a dramatic difference in other studies."
Diabetes is a growing world-wide medical problem, McMurray and Califf noted. Some 150 million people now have the disease -- 90 percent have type 2 diabetes -- and the incidence is predicted to increase 50 percent by 2025.
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