Slowing Prediabetes Defuses Heart Disease

Prediabetes treatment early on may lower heart disease risk with medication and lifestyle changes

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) For those with prediabetes, blood sugar levels are high but not high enough to be diabetes. If patients don’t take action, however, they risk getting not only diabetes but heart disease as well.

In 2011, about 280 million people worldwide, or 6.4 percent of adults, were estimated to have prediabetes, or impaired glucose tolerance (IGT), according to the International Diabetes Foundation. Medication to control blood sugar and lifestyle changes (losing weight and exercise) may help ward off type 2 diabetes in these patients.

Recent research shows that these two treatments may also improve cholesterol levels and reduce heart disease risk in people with IGT.

"Maintain a healthy weight to help reduce diabetes risk."

Ronald Goldberg, MD, a professor of medicine at the University of Miami's Miller School of Medicine in Florida, specializing in endocrinology, diabetes and metabolism, and colleagues analyzed blood samples from 1,645 people with IGT.

Participants were randomly assigned to one of three groups: one taking the medication metformin, one taking a placebo (fake medication) or one that followed an intensive lifestyle modification program.

Metformin (brand names Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) decreases the amounts of glucose (sugar) absorbed from food and made by the liver. It also heightens the body’s response to insulin, a substance that controls the amount of glucose in the blood.

The lifestyle modification group had goals to achieve and had to maintain a weight reduction of at least 7 percent of initial body weight through eating a low-calorie, low-fat diet and engage in moderate physical activity for at least two and a half hours per week.

To evaluate the effects of the three different interventions, investigators compared the blood samples taken at the start of the study to samples taken one year later.

Those in the lifestyle modification group had lower levels of triglycerides and the particles that carry this kind of fat in the blood. Triglycerides are the chemical form in which most fat exists in food as well as in the body, and excess triglycerides are associated with coronary artery disease in some people.

Blood samples from both the metformin and the lifestyle group revealed lower levels of small low-density lipoprotein (LDL), or the “bad cholesterol,” which has been shown to contribute to plaque buildup in arteries.

Both these groups also exhibited increases in high-density lipoproteins (HDL), a form of cholesterol that may slow the progression of atherosclerosis and lower heart disease risk.

“Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person's blood,” Dr. Goldberg said in  a press release. “Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population.”

This study was published online on August 27 in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The research received support from Bristol-Myers Squibb, Lipha Pharmaceuticals, Inc. and Parke-Davis.

Review Date: 
August 27, 2013
Last Updated:
August 27, 2013