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Impaired glucose tolerance: do pharmacological therapies correct the underlying metabolic disturbance?

Ralph A Defronzo

Diabetes Division, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA, albarado{at}uthscsa.edu

Lifestyle intervention prevents or delays the conversion from impaired glucose tolerance (IGT) to type 2 diabetes. However, many subjects fail to achieve and/or maintain long-term weight loss and to follow a regular exercise regimen may require pharmacologic therapy. Insulin resistance in liver, muscle and fat, along with impaired beta-cell function, plays a central role in the pathogenesis of type 2 diabetes. Insulin sensitising drugs, including metformin and the thiazolidinediones, have significantly reduced the conversion rate of IGT to type 2 diabetes in subjects in several large, well designed clinical trials. Insulin-sensitising drugs are likely to play an important role in future strategies for diabetes prevention.

Key Words: insulin resistance • beta-cell dysfunction • metformin • thiazolidinediones • type 2 diabetes • impaired glucose tolerance.

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The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 1 suppl, S24-S40 (2003)
DOI: 10.1177/14746514030030010601
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