Diabetes Prevention Trial

Doctors seeking at-risk people aged 50 and above for world's largest diabetes prevention trial

Australian doctors are calling for people aged 50 and above who are at risk of developing type 2 diabetes, to enrol in the world's largest-ever diabetes prevention trial.

The trial will examine ways of preventing the onset of, or delaying progression to type 2 diabetes and cardiovascular disease (CVD) in people who have a condition known as impaired glucose tolerance or IGT.

IGT affects about one in eight Australians over the age of 40 and almost all of those affected are unaware of it. The condition can only be diagnosed with a simple blood test.

According to Dr Greg Fulcher, Director, Department of Endocrinology, Royal North Shore Hospital, participation in this international trial will assist Australian doctors in determining whether development of type 2 diabetes can be delayed, thereby reducing complications associated with the disease.

"Once diabetes is established, it is very difficult to control. If we can treat people early enough, then it may be possible to delay the progression of the disease which has severe health risks, including cardiovascular disease, blindness and kidney damage."

Anyone without diabetes aged 50 and above may be eligible to participate in this trial.

Doctors are particularly seeking people who meet any of the following criteria:

• Overweight and have little exercise
• High blood pressure or cholesterol
• Heart or blood vessel disease
• A smoker
• A relative with type 2 diabetes
• Abnormal blood sugar during pregnancy or other occasion

"We are looking for people with IGT as they are already at risk of going on to develop type 2 diabetes," said Dr Fulcher.

"We are also seeking people who are at increased risk of cardiovascular disease, such as those with high blood pressure or high cholesterol, or smokers."

Dr Fulcher is urging people who are interested in participating in this trial to call (freecall) 1800 800 502 to register their interest.

Callers will be screened and may be offered further tests to confirm their eligibility.
Studies show exercise and weight loss may control IGT. All participants in the trial will therefore be offered an internationally-developed healthy lifestyle program considered to be highly beneficial in managing IGT.

Most participants will also receive medicines that may potentially help to prevent or delay the development of type 2 diabetes and cardiovascular disease.

Because IGT and cardiovascular disease often happen at the same time, this trial is testing two treatments together: a fast-acting medicine that acts at meal times to control glucose spikes by increasing insulin secretion, and another medicine that controls high blood pressure and may also improve insulin action.

Both treatments are currently approved for use in Australia: one for treating type 2 diabetes and the other for high blood pressure.

Researchers are now examining new uses of these medicines to control IGT.

Already more than one million Australians have diabetes.

The current healthcare bill of $3 billion for diabetes is expected to blow out to $6 billion if Australia's most rapidly growing chronic disease is not contained.

Dr Fulcher says that this is why this international trial has important implications not only for those at risk of developing diabetes, but also for the broader community at large.

"Type 2 diabetes is a disease which has a huge burden for both the individual and the community.

"Participation in this study by those at risk of developing the disease provides us with the opportunity to reduce that burden," he said.

Participants will be followed-up for six years in the trial. They will be required to visit their local study centre several times in the first six months of the trial and then every six months thereafter.

There are 10 study centres Australia-wide participating in this trial, including:

• NSW: Royal North Shore Hospital (St Leonards) and Concord Hospital (Concord), Sydney and the Diabetes Centre, Wollongong
• ACT: Canberra Hospital (Garran), Canberra
• VIC: International Diabetes Institute (Caulfield), Box Hill Hospital (Box Hill) and the Monash Medical Centre (Clayton), Melbourne
• SA: SA Endocrine Clinical Research (Keswick), Adelaide
• QLD: Royal Brisbane Hospital (Herston), Brisbane
• WA: Sir Charles Gairdner Hospital (Nedlands), Perth.

People wishing to register their interest in this diabetes prevention trial should call 1800 800 502.

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Robert Flower

Sydney-sider, Robert Flower, 55, enrolled in global trial for a potential impaired glucose tolerance (IGT) treatment

Robert Flower, 55, lives in Sydney. He enjoys going to the movies, attending concerts and walking in National Parks. His former hobbies include playing the bagpipes in a military band, Australian Rules Football and social cricket. He suffers from slight hypertension, mature-age asthma and had his gallbladder removed a number of years ago. Robert was identified by a doctor at the Royal North Shore Hospital, Sydney as a suitable candidate for the world's largest diabetes prevention trial, in which he has chosen to enrol.

This is Robert's story.

1. Do you have a family history of diabetes or cardiovascular disease (CVD) and how and when did you discover that you had impaired glucose tolerance (IGT)?
   I have a family history of type 2 diabetes. My mother developed type 2 diabetes in her mid 70s and my grandmother died of complications associated with diabetes in the 1930s when there was no effective management available.
   When I became aware that a family history of diabetes was a risk factor, I had a test to determine whether I had IGT. My hypertension was picked up by my GP about six years ago.
   
   
2. What did your doctor say about your IGT or CVD risk factors?
   I only found out about my IGT a few weeks ago when I enrolled in the study.
   
   
3. How have you been trying to prevent developing type 2 diabetes to date?
   I haven't really being trying to prevent developing type 2 diabetes. In fact, I wasn't aware that because my mother had diabetes, I was at risk. She was 75 when she was diagnosed, so I thought maybe it would be something I would only have to worry about when I reached that age.
   
   
4. Why have you decided to enrol in this trial?
   I have decided to enrol in this trial because if it can prevent me from developing type 2 diabetes, that's a worthwhile objective. Complications such as impaired vision are something that I would definitely not like to experience.
   
   
5. What have you heard about the aim of the treatments that you are trialling?
   I have heard that the aim of the treatments I am trialling is to flatten out blood glucose levels.