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- July 20, 2008 |
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CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"TheTRIPOD and PIPOD Studies"Prof. Thomas A. Buchanan (biography)
English - 2005-04-15 - 24 minutes
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Summary :
The Troglitazone in Prevention of Diabetes (TRIPOD) and Pioglitazone in Prevention of Diabetes (PIPOD) studies were conducted in Hispanic-American women with recent gestational diabetes. TRIPOD was a randomized, placebo-controlled trial in which 236 of 266 randomized subjects had at least one follow-up visit and 126 women completed 3.6 years of treatment and 8 months of post-drug washout. The main findings were (a) a 55% reduction in the incidence of diabetes during a median of 30 months on troglitazone, 400 mg/d, (b) close association between reduction in insulin output during IVGTTs at three months on trial ("ß-cell rest) and protection from diabetes, (c) persistent protection from diabetes 8 months post-drug, and (d) stable glucose and ß-cell function for 4.5 years in women who did not get diabetes during troglitazone treatment. The PIPOD study was an open-label treatment with pioglitazone, 45 mg/d, in women who completed TRIPOD. 89 of 95 eligible women without diabetes enrolled for 3 years of drug treatment and 6 months post-drug washout. The annual diabetes rate was 4.6%. Multivariate analysis revealed two independent predictors of diabetes: OGTT glucose area at baseline (higher = greater risk) and change in IVGTT total insulin area at one year (fall = lower risk). ß-cell function (disposition index) did not change significantly during PIPOD (p=0.81) even in women who had manifested a 33% fall in DI (p=0.003) during placebo treatment in the TRIPOD study. Together, the TRIPOD and PIPOD studies demonstrate that prevention of type 2 diabetes is possible through ß-cell rest.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The nature of pre-diabetes (type 2)
- The effects of thiazolidinediones on progression to diabetes
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