Present and Future

Researchers Discover New Way to Reduce Development of Diabetes

Memphis, Tenn. (March 30, 2011) The research of two University of Tennessee Health Science Center (UTHSC) scientists is included in the current issue of the New England Journal of Medicine, the oldest continuously published medical periodical. UTHSC scientists Abbas Kitabchi, PhD, MD, Maston K. Callison Professor, and Frankie B. Stentz, PhD, associate professor, both in the Department of Medicine Endocrinology, in the UT College of Medicine, contributed to the article titled, "Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance."

The study examined whether pioglitazone can reduce the risk of type 2 diabetes mellitus in adults with impaired glucose intolerance (IGT). As compared with placebo, pioglitazone taken in pill form once every morning reduced the conversion of IGT to diabetes by 72% in individuals whose obesity, ethnicity, and other markers put them at highest risk for the disease. Study participants who took pioglitazone did, however, exhibit significant weight gain and edema, swelling caused by excess fluid retention, but not heart failure.

Type 2 diabetes mellitus affects 24 million Americans and its prevalence is increasing. Eye, kidney and heart disease complications are common in type 2 diabetes mellitus and are related to both the severity and the duration of hyperglycemia, abnormally high blood sugar.

The study enrolled 602 participants in eight locations: the main site in San Antonio, Texas, and seven collaborating centers one at UTHSC here in Memphis. Study results have direct implications for the care of 79 million Americans (2010 estimate) who are pre-diabetic. IGT is associated with increased rates of cardiovascular disease, as well as conversion to type 2 diabetes mellitus. Interventions that may prevent or delay such occurrences are of great clinical importance.

"This landmark paper shows that it is possible to slow the development of type 2 diabetes mellitus," said Guy L. Reed, MS, MD, Lemuel Diggs Professor of Medicine, and chairman of the Department of Medicine in the UT College of Medicine. "Diabetes is an enormous public health problem in Memphis and the United States. Coverage of this study in the most important journal published in the field of clinical medicine is a noteworthy achievement."

According to the Texas researcher who served as the principal investigator for the study, the 72 percent reduction is the largest decrease in the conversion rate of pre-diabetes to diabetes that has ever been demonstrated by any intervention, be it diet, exercise or medication.

Pioglitazone is marketed as Actos® by Takeda Pharmaceutical Co. Ltd., the Japanese company that provided an independent investigator grant to conduct the ACT Now study. Some patients were followed for as long as four years; the median follow-up was 2.4 years.

The New England Journal of Medicine is the most widely read, cited, and influential general medical periodical in the world. NEJM is dedicated to bringing physicians the best research and key information at the intersection of biomedical science and clinical practice, and to presenting the information in an understandable and clinically useful format. A career companion for physicians, NEJM keeps practicing physicians informed on developments that are important to their patients and keeps them connected to both clinical science and the values of being a good physician. NEJM has earned and sustained its reputation as the "gold standard" for quality biomedical research and for the best practices in clinical medicine for nearly 200 years.