The DREAM trial demonstrated that rosiglitazone reduces incident diabetes or death by 60% and achieves normoglycaemia in 50% of high-risk adults with impaired glucose tolerance, the largest pharmacological diabetes prevention effect documented in a large RCT, but the drug’s subsequent cardiovascular safety concerns and market withdrawal have prevented translation of these findings into clinical practice.
Browsing: Metabolism
Obesity and weight management, metabolic syndrome and insulin resistance, MASLD/fatty liver, and nutrition and lifestyle evidence.
The Diabetes Prevention Program demonstrated that intensive lifestyle intervention reduces type 2 diabetes incidence by 58% with a NNT of 6.9 over 2.8 years in high-risk adults, outperforming metformin which reduced incidence by 31%, establishing structured lifestyle modification as the primary preventive strategy for pre-diabetes and the evidence base for national prevention programmes.
UKPDS 34 demonstrated that metformin reduces diabetes-related endpoints, death, and all-cause mortality by 32–42% in overweight patients with newly diagnosed type 2 diabetes, with superior cardiovascular outcomes compared with sulphonylurea or insulin, establishing metformin as the preferred first-line pharmacological therapy for type 2 diabetes for the subsequent three decades.
A double-blind RCT finds vitamin D improves insulin secretion and HOMA-IR but not fasting glucose in women with prediabetes. PICO summary and clinical expert commentary.
An RCT reports HIIT plus mindfulness breathing improves metabolic, hormonal, and tumour-marker profiles in obese postmenopausal women. PICO summary and critical expert commentary.
An RCT reports resistance exercise plus metformin improves glycaemic control and sleep quality in elderly type 2 diabetes with sleep disorders. PICO summary and expert commentary.
A pilot RCT finds prebiotic inulin enriches SCFA-producing gut bacteria but does not improve HbA1c in Indian children with type 1 diabetes. PICO summary and expert commentary.
A three-arm RCT shows adding a high-protein, low-GI diet to training cuts IL-6 and hs-CRP and improves insulin sensitivity in men with abdominal obesity. PICO summary and commentary.
A qualitative study finds US Dietary Guideline patterns lack cultural relevance for African American adults at risk of type 2 diabetes. PICO summary and expert commentary for clinicians.
An RCT finds adding a ketogenic diet to dulaglutide improves glucose, lipids, and insulin resistance in type 2 diabetes. PICO summary and clinical expert commentary.