Ruiz Juan
Service d'endocrinologie, diabétologie et métabolisme, Département de médecine interne CHUV, Lausanne.
Rev Med Suisse. 2007 Jan 17;3(94):132, 134-6.
This article summarizes an important study published in 2006 in the field of the prevention of diabetes mellitus. It is the DREAM study which evaluate the therapeutic effects of rosiglitazone and ramipril versus placebo in the prevention of type 2 diabetes in high risk patients: glucose intolerance or impaired fasting glucose. In this clinical study, more than 5000 patients were followed during 3 years. The risk of diabetes was reduced with rosiglitazone of 62% (NNT 9). In the field of negative effects the risk of cardiac insufficiency was multiplied by 7 (NNH 250) but stayed a rare event (to 0,5% of the treated subjects). The ramipril had no preventive effect for the prevention of type 2 diabetes but induced a higher frequency of return towards the normoglycaemia. This treatment can be recommended for these high risk subjects.
本文总结了2006年发表在糖尿病预防领域的一项重要研究。这就是DREAM研究，该研究评估了罗格列酮和雷米普利与安慰剂相比，在预防高危患者（糖耐量异常或空腹血糖受损）2型糖尿病方面的治疗效果。在这项临床研究中，5000多名患者被随访了3年。罗格列酮使糖尿病风险降低了62%（需治疗人数为9）。在副作用方面，心脏功能不全的风险增加了7倍（不良事件发生数为250），但仍然是罕见事件（在接受治疗的受试者中为0.5%）。雷米普利对预防2型糖尿病没有预防作用，但能使血糖恢复正常的频率更高。这种治疗方法可推荐给这些高危患者。
