From Pennington, New Jersey, USA:
I am 36 years old, and am overweight. I have a family history of diabetes, and I had gestational diabetes with my first child (but not with my second). My blood sugars are normal, and I am not pregnant, but a family practice doctor had a review course for her boards, and was advised to treat a patient like me with Rezulin which would increases my body's sensitivity to insulin, sparing my pancreas, and delaying the "burnout". Rezulin won't lower your sugars below normal; It basically makes your own insulin work better, she said. I have read only bad things about Rezulin. What are your recommendations about treating someone at risk for diabetes, but who doesn't have it yet?
The recently released Diabetes Prevention Program (DPP) tested individuals with impaired glucose tolerance (equivalent to the recently favored term, prediabetes). This study tested four strategies -- a control group, intensive lifestyle change, Glucophage [metformin], and Rezulin [troglitazone]. Rezulin was stopped because of liver disease in study subjects. Therefore, no conclusions from the study were made regarding Rezulin in the prevention of diabetes. Rezulin is not available anymore because of increased liver toxicity, although It may turn out that other agents from the same class of drugs as Rezulin [the "glitazones" or thiazolidinediones] may turn out to be a good strategy. However, lifestyle intervention had most potent effect, and metformin also had benefit in individuals who were younger and more obese.
The TRIPOD (TRoglitazone In the Prevention Of Diabetes) Study looked at 235 Hispanic women with previous gestational diabetes. They either received Rezulin or placebo. The findings suggested that there was a prevention of greater than 50% over 30 months in the development of type 2 diabetes. Rezulin is now withdrawn from the market. However, other agents from this class may work similarly. [ED: See Azen SP, Peters RK, Berkowitz K, Kjos S, Xiang A, Buchanan TA. Control Clin Trials 1998 Apr;19(2):217-31.
Original posting 10 May 2002
Posted to Research: Causes and Prevention
Last Updated: Tuesday April 06, 2010 15:09:34
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