Although Fonseca was not involved in this study, he disclosed that he is a paid consultant to Takeda Pharmaceuticals as a member of its new drug data safety monitoring board.
DeFronzo, however, recommended initiating drug treatment and lifestyle changes at the same time in people who are at a high risk of developing type 2 diabetes. People at high risk of type 2 diabetes include people with a family history of diabetes, women who've had gestational diabetes, Hispanics, blacks or Native Americans, people with metabolic syndrome, people who are overweight or obese, and those who have higher levels of glucose intolerance, he said.
"If someone is at high risk, then I would, in addition to trying to get them to lose weight and exercise, recommend medication, and personally, I favor pioglitazone. If you can really lose 30 pounds -- or whatever it is you need to lose -- then you might be able to discontinue the medication," said DeFronzo. "It's important to intervene early, rather than later, to save beta cell function."
Learn more about prediabetes from the American Diabetes Association.
SOURCES: Ralph A. DeFronzo, deputy director, Texas Diabetes Institute, and chief, diabetes division, University of Texas Health Science Center, San Antonio; Vivian Fonseca, M.D., president-elect, medicine and science, American Diabetes Association; March 24, 2011, New England Journal of Medicine
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