WHAT IS PREDIABETE?

Prediabetes is a condition in which a person displays a high fasting blood sugar level (6.1 to 6.9 mmol/L) or a blood sugar level between 7.8 and 11 mmol/L two hours after an oral glucose tolerance test (75 g of glucose). Dr Chiasson is concerned because this condition carries an increased risk not only of progressing to diabetes,but also of causing cardiovascular problems. In his view, patients need to be treated at this stage. To this end, he is participating in the ACE study, a major new clinical research project.  

ACE, A GOOD CARD?

Funded by Bayer Laboratories, the ACE study is an original research project including 7,500 patients with prediabetes who have experienced a cardiovascular event. The study’s objective is to assess the efficacy of the drug acarbose in preventing the incidence of mortality, myocardial infarction and cerebrovascular accidents as well as the development of type 2 diabetes in prediabetes patients.

An earlier international study directed by Dr Chiasson demonstrated that acarbose reduced the risk of developing diabetes by 36% by reducing blood sugar levels after meals. Acarbose also reduced the risk of cardiovascular events by 49%. Encouraged by these results, Dr Chiasson has undertaken this new study to confirm the cardiovascular effects of acarbose in amuch larger population. “Our hope is that the ACE study will prove that acarbose can prevent cardiovascular events as well as the progression from prediabetes to diabetes,”says Chiasson.

WHY CHINA?

If the starting point of Chiasson’s concerns is in Canada, why conduct research on the other side of the globe? “For two reasons,” notes Chiasson: “Given the size of China’s population, it is much easier to assemble the very large study group (7,500 subjects) we need to confirm our results beyond a shadow of a doubt. And secondly, type 2 diabetes is on the rise in this country and is well on the way to assuming epidemic proportions.” The project’s findings will be equally valid for Canada and other  countries because the cause of type 2 diabetes is the same regardless of national or ethnic origin. 

TOWARDS SYSTEMATIC SCREENING

If the ACE study provides the necessary confirmation of the effectiveness of Acarbose in reducing the development of cardiovascular complications in at-risk populations, Chiasson feels that it will also provide convincing arguments in favour of adopting preventive measures. In his view, these measures should include systematic screening and preventive treatments. The stakes are quite high. The WHO estimates that if unchecked,type 2 diabetes will affect more than 300 million people worldwide by 2020. Nevertheless,Dr Chiasson remains optimistic: “To the extent that the results of this study and others throughout the world find their way into public health measures, there is no reason why we cannot stem this epidemic."