Pharmacologic Randomized Clinical Trials in Prevention of Type 2 Diabetes

Purpose of Review: There have been many randomized clinical trials testing lifestyle and drug interventions to prevent the development of type 2 diabetes in nondiabetic adults at high risk of the disease. We review the major trials using pharmacologic interventions with the primary outcome of preventing diabetes. The trials are grouped according to the main mechanism by which the drugs were thought to have the potential for preventing diabetes. Recent Findings: Drugs in several different classes have been effective in reducing the incidence of diabetes, but evidence for other long-term benefits, such as avoidance of complications and reducing mortality rates, is very limited. Summary: Both drugs and lifestyle interventions are effective in preventing and delaying the onset of type 2 diabetes in high-risk adults. The choices of what drugs to use and when during the development of type 2 diabetes to introduce them are not clear.