An injected drug that reduces blood sugar and promotes weight loss can cut the chances of at-risk patients developing type 2 diabetes by 80%, research has shown.
The drug, liraglutide, interacts with brain regions that control appetite and energy intake.
A major international trial involving participants here in Ireland found that treatment with liraglutide had a dramatic effect on diabetes risk in obese and "pre-diabetes" patients en route to becoming chronically diabetic.
One in 10 of the population here is thought to have pre-diabetes, a metabolic condition closely tied to obesity.
Findings from the Scale study, which recruited 2,254 adults with pre-diabetes in 27 countries worldwide, are published in The Lancet medical journal.
The participants were randomly given either liraglutide 3.0 mg or a placebo delivered by injection under the skin once daily for 160 weeks.
They were also placed on a reduced calorie diet and a regime of increased physical activity.
After 3 years of taking the drug once a day in combination with diet and increased physical activity, the risk of developing type 2 diabetes reduced by 80%, while those taking the medicine also had greater sustained weight loss compared to the placebo.
Liraglutide is based on a hormone called GLP-1, which is 97% similar to the naturally occurring human hormone GLP-1 1.
The drug promotes weight loss by interacting with the areas of the brain that control appetite and energy intake.
One of the authors on the study is Professor Carel le Roux from the UCD Diabetes Complications Research Centre, UCD School of Medicine and Fellow, UCD Conway Institute, who said the associated health costs of treating those with diabetes in Ireland is significant.
"Individuals are at risk of a range of conditions that can affect their overall health including type 2 diabetes and its complications as well as cardiovascular disease and cancer," Professor le Roux said.
"In this study, we wanted to see if this drug in combination with a reduced-calorie diet and lifestyle intervention could delay the onset of type 2 diabetes in a high-risk population with obesity and prediabetes."
"On the basis of our findings, liraglutide 3.0 mg can provide us with a new therapeutic approach for patients with obesity and prediabetes to substantially reduce their risk of developing type 2 diabetes and its related complications."
"The reduction in risk of progression to diabetes from prediabetes is clearly desirable," said Dr Francis Finucane, the lead investigator for the study at the HRB Clinical Research Facility at Galway University Hospital which coordinated the trial in Ireland.
"The challenge now is to make these drugs available in an efficient and cost effective way to those patients who will benefit most from them."
Meanwhile, a separate study found that severe gum disease, known as periodontitis, may be an early sign of type 2 diabetes.
The study, published in the journal BMJ Open Diabetes Research and Care, examined 313 predominantly middle-aged people attending a university dental clinic - 109 had no gum disease, 126 had mild to moderate gum disease, and in 78 it was severe, affecting the supporting structures of the teeth.
Each undertook a finger pinprick test to examine their blood sugar levels to determine whether or not patients had "pre-diabetes".
HbA1C values, which measure the average level of blood sugar in the body over the past two to three months, were highest in those with the most severe form of gum disease, researchers from the Netherlands found.