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DIABETES VIDEO: Nateglinide Does Not Stave Off Diabetes, Cardiovascular Disease Among High Risk Patients
DIABETES VIDEO: Nateglinide Does Not Stave Off Diabetes, Cardiovascular Disease Among High Risk Patients

(April 21, 2010 - Insidermedicine)

The short-acting insulin secretagogue nateglinide does not help stave off diabetes or cardiovascular vents among high risk patients with impaired glucose tolerance, according to a trial published in the latest issue of the New England Journal of Medicine.

Here are some recommendations for the prevention of diabetes, from the American Diabetes Association:

•    A structured program should emphasize lifestyle changes that include moderate weight loss (7% body weight) and regular physical activity (150 min/week

•    Dietary strategies should include reduced calories and reduced intake of dietary fat

•    Diet should include 14 g dietary fiber/1,000 kcal and foods containing whole grains

Researchers representing the NAVIGATOR Study Group randomized 9,306 patients with impaired glucose tolerance and either cardiovascular disease or cardiovascular risk factors to receive nateglinide up to 60 mg three times daily or a placebo. The study also involved randomization to treatment with valsartan or placebo, in a 2-by-2 factorial design, and all participants engaged in a lifestyle modification program.

After a median follow-up of five years, the cumulative incidence of diabetes was 36% in the nateglinide group and 34% in the placebo group. There was also no difference between nateglinide or placebo users with regard to the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure or hospitalization for unstable angina or arterial revascularization. Patients taking nateglinide did, however, have an increased risk of hypoglycemia.

Today’s research suggests that short-acting insulin secretagogues are not effective for reducing the risk of diabetes or cardiovascular events among high risk patients.

 
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