[Experiences of the DREAM trial]

This review is based on the papers presented in the New England Journal of Medicine and the Lancet. Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. On the other hand, rosiglitazone, a thiazolidinedione, can reduce insulin resistance and might preserve insulin secretion. To asses prospectively the ability of these drugs to prevent type 2 diabetes in individuals at high risk for developing this condition. The results provide clear evidence, that among persons with impaired fasting glucose levels or impaired glucose tolerance, the use of 15 mg ramipril for 3 years does not significantly reduce the incidence of type 2 diabetes or death but does significantly increase regression to normoglycaemia. In the same population rosiglitazone at 8 mg daily for 3 years substantially reduces the incidence of type 2 diabetes and increases the regression to normoglycaemia.