Table 6.
Key evidence for diabetes prevention: pharmacologic interventions
| Study | Participants | No. | Intervention | Study duration (yr) | Outcomes |
|---|---|---|---|---|---|
| STOP-NIDDM study (2002) [82] | IGT | 1,429 | Acarbose 100 mg tid | 3.3 | 25% Reduction in intervention group |
| Diabetes Prevention | Overweight, IFG, or IGT | 3,234 | Lifestyle modification | ||
| Program (2002) [56] | Metformin 850 mg bid | 2.8 | 31% Reduction in metformin group | ||
| XENDOS (2004) [83] | BMI ≥30 kg/m2, NGT or IGT | 3,305 | Orlistat 120 mg tid | 4 | 37.3% Reduction in orlistat group |
| Indian Diabetes | IGT | 531 | Lifestyle modification | 3 | Lifestyle modification 28.5% |
| Prevention | Metformin 250 mg bid | Metformin 26.4% | |||
| Programme [58] | Lifestyle modification & metformin 250 mg bid | Lifestyle modification & metformin 28.2% | |||
| Voglibose Ph-3 study (2009) [84] | IGT | 1,780 | Voglibose 0.2 mg tid | 3 | 40% Reduction in voglibose group |
| NAVIGATOR (2010) [85] | IGT with cardiovascular disease or cardiovascular disease risk factors | 9,306 | Lifestyle modification+valsartan 160 mg/day (maximal dose) | 5 | 14% Reduction in valsartan group |
| ACT NOW (2011) [86] | BMI ≥25 kg/m2, IGT | 602 | Pioglitazone 45 mg qd | 2.4 | 72% Reducation in pioglitazone |
| SEQUEL substudy (2014) [87] | Prediabetes in SEQUAL trial participants | 475 | Phentermine | 2 | 70.5% and 78.7% in phetermine/topiramate ER, repectively |
| Topiramate ER 7.5/46 mg, 15/92 mg | |||||
| IRIS (2016) [88] | Recent ischemic stroke or TIA and insulin resistance (HOMAIR ≥3.0) but not diabetes | 3,876 | Pioglitazone 45 mg qd | 4.8 | 52% Reduction in pioglitazone group |
| SCALE (2017) [89] | Preidabetes (BMI ≥30 kg/m2), dyslipidemia or hypertension with BMI ≥27 kg/m2 | 2,254 | Liraglutide 3 mg qd | 3 | 79% Reduction in liraglutide |
| ACE trial (2020) [90] | IGT with coronary artery disease | 6,522 | Acarbose 50 mg tid | 5 | 18% Reduction in acabose group |
STOP-NIDDM, The Study to Prevent Non-Insulin-Dependent Diabetes Mellitus; IGT, impaired glucose tolerance; tid, three times a day; IFG, impaired fasting glucose; bid, twice a day; XENDOS, XENical in the prevention of diabetes in obese subjects; BMI, body mass index; NGT, normal glucose tolerance; NAVIGATOR, Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research; ACT NOW, Actos Now for Prevention of Diabetes; qd, once a day; SEQUEL, Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults; ER, extended-release; IRIS, Insulin Resistance Intervention after Stroke; TIA, transient ischemic attack; HOMA-IR, homeostasis model assessment of insulin resistance; SCALE, Satiety and Clinical Adiposity-Liraglutide Evidence in Nondiabetic and Diabetic Individuals; ACE, Acarbose Cardiovascular Evaluation.