Hot off the press: the CANOE trial


Despite the popularity of “how to” books on transforming our lives we Americans really do not like life-style change. This is one reason there has been such hesitancy in setting up to screen large numbers of people for insulin resistance – the first sign of insipient type 2 diabetes. Previous trials in which pre-diabetic people have been identified have failed to stop their march into that state of full blown diabetes – underscoring the incredible difficulty in real life style change.

We do like to take pills, however. This may explain the success of the most recent clinical trial in which 207 pre-diabetic patients were given either placebo or else a low-dose combination of rosiglitazone and metformin. The double blind trial was funded by GlaxoSmithKline and just reported today in the Lancet by Dr. Bernard Zinman and colleagues. The patients were followed for almost 4 years. Forty one patients (39.4%) in the placebo group developed diabetes. Fourteen patients (13.6%) in the treatment group developed diabetes. A great many metabolic variables were examined and nothing really changed (at least that I picked up on). Weight was unchanged as well. No serious side effects were reported.

So it looks like we have a winner. My only question is how they got the acronym “CANOE” from rosiglitazone, metformin, and prediabetes. Perhaps some things should remain a mystery.

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