Waking up from the DREAM of preventing diabetes with drugs.

them to high dose rosiglitazone or placebo.4 The trial effectively concealed allocation, adhered to the intention to treat principle, and achieved negligible loss to follow-up after a median follow-up of three years. The trial’s primary outcome was a composite end point of death and the diagnosis of diabetes. It was stopped early after almost 1000 primary end points had accumulated because of benefit in the treatment arm (table 1). The authors noted that for every 1000 people treated with rosiglitazone 8 mg/day for three years, about 144 people who would otherwise cross the glucose threshold we call diabetes will not do so; four to five patients without congestive heart failure will develop the condition. Waking up from the DREAM of preventing diabetes with drugs