Waking up from the DREAM of preventing diabetes with drugs

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Abstract
Preventing diabetes Several randomised trials have shown that modest weight loss and physical activity can greatly reduce the risk of diabetes.5 6 7 The Diabetes Prevention Program documented a 58% relative risk reduction (confidence interval 48% to 66%) in high risk individuals5; other trials have shown similar results.6 7Nevertheless, the possibility of preventing diabetes with drugs has caught the imagination of the drug industry. The medicalisation of pre-disease states and risk factors has become increasingly common, including targets of precursors of hypertension, osteopenia, and obesity. The prospect of marketing existing drugs to otherwise healthy people greatly expands the market for these drugs while increasing costs for society, increasing use of health care, and potentially reducing quality of life by converting healthy people into patients.8 9