Diabetes Treatments Offer Cardiovascular Benefits

Tuesday, September 3, 2013. An article published online on August 26, 2013 in the Journal of Clinical Endocrinology & Metabolism reports the finding of Ronald Goldberg, MD of the University of Miami and his associates of a positive effect for the antidiabetic drug metformin or lifestyle interventions in reducing risk factors for cardiovascular disease in adults with impaired glucose tolerance, who are at increased risk of developing type 2 diabetes.

The current study included 1645 participants in the Diabetes Prevention Program who were randomized to receive metformin, a placebo, or an intensive program of lifestyle modification (which had the goal of producing 7% weight loss by combining a low fat diet with increased physical activity). Blood samples collected at the beginning of the study and after one year were analyzed for lipids and other factors.

At the end of the treatment period, participants in the metformin intervention and the lifestyle modification program had lower levels of small and dense low-density lipoprotein (LDL) particles and increases in high-density-lipoproteins (HDL). Those following the lifestyle program also experienced a reduction in triglycerides as well as large and buoyant VLDL particles. These changes could help reduce the risk of atherosclerosis, a common complication of diabetes.

"Cardiovascular disease is the most significant cause of death and disability in people with diabetes," noted Dr Goldberg, who is affiliated with the University of Miami's Miller School of Medicine. "Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease."

"We show for the first time in a year-long study involving a large, multiethnic high-risk group that intensive lifestyle change and metformin treatments, previously demonstrated to slow diabetes development, also produced widespread and mostly favorable alterations in lipoprotein subfractions, using techniques that yielded corroborative changes in size and density," the authors announce. "The findings offer optimism that these interventions in addition to slowing diabetes development may also slow progression of atherosclerosis.

"Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person's blood," Dr Goldberg affirmed. "Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population."