What are your thoughts on the current state of preventive diabetes measures?
Diabetes is a real scourge. It's a very common disorder, and it's becoming more common by the day. To me, one of the pieces we have not focused on adequately is the prevention of diabetes. I like to say that friends don't let friends get diabetes, so I'm really into the prevention of diabetes.
A major population of focus is the so-called "pre-diabetic," where the patient has metabolic syndrome and some resistance — the patient who is on his or her way to getting diabetes. I am very grateful that there's been increasing focus in the last many years on prevention of diabetes. We have several trials now that look at prevention of diabetes in the pre-diabetic patient. We have excellent evidence for diet and lifestyle. Even though we as clinicians tend to sometimes short-circuit that, if we're dealing with a patient who has insulin resistance, hypertriglyceridemia, metabolic syndrome, the odds that appropriate diet and exercise will help that patient are extremely high.
That doesn't make it easier for us to say, it doesn't make it easier for the patient to do, but to understand how useful it is I think is a huge step forward.