Canadian researchers report that the drug, Avandia, approved for the treatment of type 2 diabetes, may help prevent the disease from developing in high-risk individuals.

In the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medications (DREAM) trial, the Canadian team randomly assigned nearly 5,300 adults from clinics in 21 countries to get 8 milligrams of Avandia or a placebo daily for three years. All of the participants were at high risk of developing type 2 diabetes, having already shown signs of poor blood-sugar control. Over the course of the trial, 280 people (12 percent) taking Avandia went on to develop type 2 diabetes compared with 658 people (26 percent) who received the placebo, the researchers report.

The DREAM researchers announced their findings at a meeting of the European Association for the Study of Diabetes, in Copenhagen. The results of the Avandia arm of the study are also published in the Sept. 15 online edition of The Lancet. The results of the Altace arm of the study will appear in the Oct. 12 print edition of the New England Journal of Medicine; the findings were released Friday, to coincide with the presentation in Copenhagen.

The president for medicine and science of the American Diabetes Association, Dr. Larry C. Deeb is horrified by the diabetic explosion going on around us. He fears that diabetes prevention is becoming a pharmacological intervention. People would rather pop a pill than implement a healthier diet and exercising. Sadly, I must agree with you, Larr. The road to hell is paved with good intentions.

My previous blog was about the meeting now underway in Copenhagen of the European Association for the Study of Diabetes (EASD). More significant news from that meeting: Galvus, the diabetes drug manufactured by Novartis, appears to work as well as GlaxoSmithKline's Avandia - but without the nasty side effects.

Galvus and Avandia are both designed to lower blood sugar levels. However, in the case of Galvus, this is achieved without causing weight gain and with less incidence of fluid retention, which is seen with Avandia. This is all good news for patients, said Emanuele Bosi of Milan's San Raffaele University, while addressing the EASD meeting. Remarked Bosi, neither patients nor their physicians should accept side effects of diabetes meds as a normal part of treatment. Great - who could disagree with that?

Naturally, this represents a major coup for Novartis in the unrelenting battle for dominance of the diabetes drug market. On the other hand, Novartis is not home free: Januvia, which works in the same way as Galvus and is manufactured by Merck & Co., should also reach markets soon enough too.

Don't call your doctor just yet though. Galvus is not yet approved for sale in the United States.

The well-informed are aware that the spread of diabetes is one of the big downsides of globalization. Unhealthy diets and sedentary lifestyles and work environments are the culprits. Yes, educating people about the causes of Type 2 diabetes is really, really important. However, the degree to which each country is able to fight the spread of diabetes also depends on how much money is available in government coffers and, in particular, what kind of access people have to quality healthcare. Eastern Europe is one region at risk.

This issue is one of the topics under discussion at the annual meeting of the European Association for the Study of Diabetes (EASD), currently underway in Copenhagen (Copenhagen and Malmoe, September 14-17, to be exact). Attending the meeting are doctors and researchers from all over Europe. Also there is Martin Silink, president of the International Diabetes Federation (IDF). Silink made some remarks at a press conference about the ability of eastern European governments to cope with ballooning healthcare costs as diabetes continues to spread in that part of the world. According to Silink, the expense of treating all those diabetics could "cripple" healthcare budgets. While diabetes is affecting about the same proportion of the populations of eastern European countries as it does in western Europe, the threat posed by the disease is greater because eastern European health systems lack the funding seen further west.

I went looking for more info about the EASD's meeting because this all sounded so interesting. Alas, neither the EASD website nor the IDF's website contained much information. However, for those interested in diabetes in a global context, the IDF will be holding it's annual conference this December in South Africa. Stay tuned.