Easing Pancreas Cells' Workload Can Prevent Or Delay Disease In Latin Women At Risk.(type 2 diabetes )

2001 JUL 12 - (NewsRx Network) -- Administering a drug to lower insulin resistance in women at high risk for type 2 diabetes appears to successfully prevent or stall onset of the disease, researchers reported on June 24, 2001, at the American Diabetes Association's 61st Annual Scientific Sessions.

The Troglitazone in Prevention of Diabetes (TRIPOD) study tested whether reducing the demands placed on beta cells, which secrete insulin in response to glucose, could prevent type 2 diabetes in Latinas with recent gestational diabetes.

Although gestational diabetes usually disappears after childbirth, patients commonly remain resistant to their own insulin and 30% to 50% of them develop type 2 diabetes within a few years after pregnancy, says Thomas A. Buchanan, University of Southern California professor of medicine, obstetrics and gynecology and physiology and biophysics.

Buchanan and colleagues gave 235 young Latinas with recent gestational diabetes a daily dose of either troglitazone or placebo. At that time, physicians in the U.S. commonly prescribed troglitazone to treat type 2 diabetes, because it helps the body's cells more effectively use insulin to absorb glucose. (The U.S. Food and Drug Administration recalled troglitazone in 2000, and USC researchers switched to prescribing pioglitazone, a similar-acting, WA-approved drug in the ongoing study).

When the body's muscle and fat cells grow resistant to insulin, the beta cells in the pancreas shift into overdrive to produce more insulin to compensate. Over time, this high workload causes beta cells to wear out in some people and produce less insulin, or stop altogether, causing type 2 diabetes. Buchanan and colleagues postulated that lessening the workload might keep the beta cells from failing, thereby preventing diabetes.

During the 30-month study, women in the placebo group were diagnosed with diabetes at a rate of more than 12% a year. Women taking troglitazone were diagnosed at a much lower rate - less than 5% a year.

Interestingly, troglitazone seemed most helpful to very insulin-resistant women. At the time these women began the study, their beta cells had to secrete a lot of insulin. But when they took troglitazone, they experienced a very large reduction in the work their beta cells had to do. None of these women developed type 2 diabetes. Women whose beta cells did not experience such a large reduction in ...