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18 March 2010

A pill a day doesn't always keep the doctor away

Research suggests that taking nateglinide or valsartan to reduce your risk of developing heart disease or stroke is not effective.

New research suggests that neither of the two drugs is effective at reducing your risk of developing heart disease or stroke if you have raised blood sugar. Nateglinide is a medicine that stimulates your body to produce more insulin. Valsartan is an angiotensin receptor blocker (ARB), which helps to widen your blood vessels and reduce your blood pressure. Research on both of these drugs was published in the New England Journal of Medicine last week.

Both studies were in one group of more than 9,300 people. All of the participants had an impaired glucose tolerance. This means they had high blood sugar levels, but had not yet been diagnosed with diabetes. The participants were randomly assigned to receive nateglinide, valsartan, both of these or a placebo (dummy) treatment.

You can't simply take a pill and hope for the best

Dr Annabel Bentley, Assistant Medical Director, Bupa

All of the participants were enrolled into a lifestyle programme. This aimed to help them reduce their weight by five percent through changes to their diet and by encouraging them to do 150 minutes of exercise each week. The participants were followed up every six months for five years with their blood glucose level monitored regularly.

The results of the studies showed that taking either nateglinide or valsartan, or both combined, did not significantly reduce the risk of developing heart disease or stroke when compared to the placebo treatment. The studies also looked at whether nateglinide or valsartan had any effect on the risk of developing type 2 diabetes. Nateglinide was shown to have no effect on the risk, but the studies suggest that taking valsartan for five years could reduce your risk by around three percent.

Bupa's Assistant Medical Director, Dr Annabel Bentley, said: "There's no quick fix to reduce the risk of heart disease and diabetes. This large trial in over 9,000 people looked at taking two drugs to reduce these risks, but little effect was seen. However, one in five of the participants did not complete the study, so this means there is not really enough data to draw a strong conclusion.

"The best way to lower your chance of diabetes or heart disease is regular physical activity and a balanced diet to stay a healthy weight. You can't simply take a pill and hope for the best."

Key facts
  • Type 2 diabetes is a lifelong condition in which the body is unable to regulate the amount of glucose in the blood properly. It develops when the body does not respond to the natural hormone insulin.
  • You are more likely to develop type 2 diabetes if:
    - you are overweight or obese
    - you don't exercise very often
    - type 2 diabetes runs in your family
    - you smoke
    - you drink alcohol excessively
    - you are of African-Caribbean, South-Asian or Hispanic origin
  • The long-term complications of type 2 diabetes include heart disease, stroke, kidney or eye damage or circulation problems in your legs and feet.
  • According to recent figures, 2.9 million people in the UK have been diagnosed with diabetes. Eight in 10 of these people have type 2 diabetes.

Related topics

Read the studies

The Navigator Study Group. Effect of Nateglinide on the Incidence of Diabetes and Cardiovascular Events. N Engl J Med:NEJMoa1001122. DOI: 10.1056/NEJMoa1001122

The Navigator Study Group. Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events. N Engl J Med:NEJMoa1001121. DOI: 10.1056/NEJMoa1001121

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