Rosiglitazone, but Not Ramipril, Prevents Progression to Diabetes in Patients at Risk

Among patients at risk for progression to diabetes, metformin and acarbose therapy each modestly reduce the likelihood of progression; dietary modifications and increased exercise are more effective but are also more difficult to maintain (Journal Watch Feb 19 2002). In a new industry-funded multinational trial, researchers explored the effectiveness of rosiglitazone, ramipril, or both in patients at risk for diabetes; ramipril was studied because angiotensin-converting–enzyme inhibitors have been associated with a lower incidence of diabetes in previous trials (done for other purposes).

Researchers randomized more than 5000 nondiabetic patients with either elevated fasting glucose levels (110–125 mg/dL) or impaired glucose tolerance (plasma…