Long-term effect of rosiglitazone and/or ramipril on the incidence of diabetes
Aims/hypothesis The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial reported that 3 years of therapy with rosiglitazone reduced the primary outcome of diabetes or death by 60%. Here we investigated whether an effect on diabetes prevention persists more than 1.5...
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| Veröffentlicht in: | Diabetologia 2011-03, Vol.54 (3), p.487-495 |
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| container_title | Diabetologia |
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| creator | Gerstein, H C Mohan, V Avezum, A Bergenstal, R M Chiasson, J-L Garrido, M MacKinnon, I Rao, P V Zinman, B Jung, H Joldersma, L Bosch, J Yusuf, S |
| description | Aims/hypothesis
The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial reported that 3 years of therapy with rosiglitazone reduced the primary outcome of diabetes or death by 60%. Here we investigated whether an effect on diabetes prevention persists more than 1.5 years after therapy has been discontinued.
Methods
The DREAM On passive follow-up study was conducted at 49 of the 191 DREAM sites. Consenting participants were invited to have a repeat OGTT 1–2 years after active therapy ended. A diagnosis of diabetes at that time was based on either a fasting or 2 h plasma glucose level of ≥7.0 mmol/l or ≥11.1 mmol/l, respectively, or a confirmed diagnosis by a non-study physician. Regression to normoglycaemia was defined as a fasting and 2 h plasma glucose level of |
| doi_str_mv | 10.1007/s00125-010-1985-4 |
| format | Article |
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The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial reported that 3 years of therapy with rosiglitazone reduced the primary outcome of diabetes or death by 60%. Here we investigated whether an effect on diabetes prevention persists more than 1.5 years after therapy has been discontinued.
Methods
The DREAM On passive follow-up study was conducted at 49 of the 191 DREAM sites. Consenting participants were invited to have a repeat OGTT 1–2 years after active therapy ended. A diagnosis of diabetes at that time was based on either a fasting or 2 h plasma glucose level of ≥7.0 mmol/l or ≥11.1 mmol/l, respectively, or a confirmed diagnosis by a non-study physician. Regression to normoglycaemia was defined as a fasting and 2 h plasma glucose level of <6.1 mmol/l and <7.8 mmol/l, respectively.
Results
After a median of 1.6 years after the end of the trial and 4.3 years after randomisation, rosiglitazone participants had a 39% lower incidence of the primary outcome (hazard ratio [HR] 0.61, 95% CI 0.53–0.70;
p
< 0.0001) and 17% more regression to normoglycaemia (95% CI 1.01–1.34;
p
= 0.034). When the analysis was restricted to the passive follow-up period, a similar incidence of both the primary outcome and regression was observed in people from both treatment groups (HR 1.00, 95% CI 0.81–1.24 and HR 1.14, 95% CI 0.97–1.32, respectively). Similar effects were noted when new diabetes was analysed separately from death. Ramipril did not have any significant long-term effect.
Conclusions/interpretation
Time-limited exposure to rosiglitazone reduces the longer term incidence of diabetes by delaying but not reversing the underlying disease process.</description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-010-1985-4</identifier><identifier>PMID: 21116607</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Biological and medical sciences ; Diabetes ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - prevention & control ; Diabetes. Impaired glucose tolerance ; Drug therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fasting ; Female ; Glucose ; Health sciences ; Human Physiology ; Humans ; Hypoglycemic Agents - therapeutic use ; Internal Medicine ; Male ; Medical research ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Plasma ; Prevention ; Ramipril - therapeutic use ; Research centers ; Thiazolidinediones - therapeutic use</subject><ispartof>Diabetologia, 2011-03, Vol.54 (3), p.487-495</ispartof><rights>Springer-Verlag 2010</rights><rights>2015 INIST-CNRS</rights><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-56f7f0bab4efe84f2b4c568ed4db510c8e793f668153f92354f203391e5eb9d93</citedby><cites>FETCH-LOGICAL-c443t-56f7f0bab4efe84f2b4c568ed4db510c8e793f668153f92354f203391e5eb9d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00125-010-1985-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00125-010-1985-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23864264$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21116607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerstein, H C</creatorcontrib><creatorcontrib>Mohan, V</creatorcontrib><creatorcontrib>Avezum, A</creatorcontrib><creatorcontrib>Bergenstal, R M</creatorcontrib><creatorcontrib>Chiasson, J-L</creatorcontrib><creatorcontrib>Garrido, M</creatorcontrib><creatorcontrib>MacKinnon, I</creatorcontrib><creatorcontrib>Rao, P V</creatorcontrib><creatorcontrib>Zinman, B</creatorcontrib><creatorcontrib>Jung, H</creatorcontrib><creatorcontrib>Joldersma, L</creatorcontrib><creatorcontrib>Bosch, J</creatorcontrib><creatorcontrib>Yusuf, S</creatorcontrib><creatorcontrib>DREAM On (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication Ongoing Follow-up) Investigators</creatorcontrib><title>Long-term effect of rosiglitazone and/or ramipril on the incidence of diabetes</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description>Aims/hypothesis
The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial reported that 3 years of therapy with rosiglitazone reduced the primary outcome of diabetes or death by 60%. Here we investigated whether an effect on diabetes prevention persists more than 1.5 years after therapy has been discontinued.
Methods
The DREAM On passive follow-up study was conducted at 49 of the 191 DREAM sites. Consenting participants were invited to have a repeat OGTT 1–2 years after active therapy ended. A diagnosis of diabetes at that time was based on either a fasting or 2 h plasma glucose level of ≥7.0 mmol/l or ≥11.1 mmol/l, respectively, or a confirmed diagnosis by a non-study physician. Regression to normoglycaemia was defined as a fasting and 2 h plasma glucose level of <6.1 mmol/l and <7.8 mmol/l, respectively.
Results
After a median of 1.6 years after the end of the trial and 4.3 years after randomisation, rosiglitazone participants had a 39% lower incidence of the primary outcome (hazard ratio [HR] 0.61, 95% CI 0.53–0.70;
p
< 0.0001) and 17% more regression to normoglycaemia (95% CI 1.01–1.34;
p
= 0.034). When the analysis was restricted to the passive follow-up period, a similar incidence of both the primary outcome and regression was observed in people from both treatment groups (HR 1.00, 95% CI 0.81–1.24 and HR 1.14, 95% CI 0.97–1.32, respectively). Similar effects were noted when new diabetes was analysed separately from death. Ramipril did not have any significant long-term effect.
Conclusions/interpretation
Time-limited exposure to rosiglitazone reduces the longer term incidence of diabetes by delaying but not reversing the underlying disease process.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Diabetes</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - prevention & control</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Drug therapy</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>Health sciences</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Plasma</subject><subject>Prevention</subject><subject>Ramipril - therapeutic use</subject><subject>Research centers</subject><subject>Thiazolidinediones - therapeutic use</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kEtrHDEQhEWIsTe2f0AuYQiYnGS3nqs5GuM8YIkvCfgmNJrWZsyMZEuzB-fXW8NuYgjkJJr-qlRdhLxncMkA1lcFgHFFgQFlrVFUviErJgWnILl5S1bLmjKj70_Iu1IeAEAoqY_JCWeMaQ3rFfm-SXFLZ8xTgyGgn5sUmpzKsB2H2f1OERsX-6uUm-ym4TEPY5NiM__CZoh-6DF6XBT94DqcsZyRo-DGgueH95T8_Hz74-Yr3dx9-XZzvaFeSjFTpcM6QOc6iQGNDLyTXmmDvew7xcAbXLciaG2YEqHlNXXgIETLUGHX9q04JZ_2vo85Pe2wzHYaisdxdBHTrlijQGmmpajkx3_Ih7TLsYazRraCKS55hdge8vX0kjHYeunk8rNlYJeq7b5qC8tcq7ayaj4cjHfdhP1fxZ9uK3BxAFzxbgzZ1cbKKyeMllwvRnzPlbqKW8yvCf__-wudNZTi</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Gerstein, H C</creator><creator>Mohan, V</creator><creator>Avezum, A</creator><creator>Bergenstal, R M</creator><creator>Chiasson, J-L</creator><creator>Garrido, M</creator><creator>MacKinnon, I</creator><creator>Rao, P V</creator><creator>Zinman, B</creator><creator>Jung, H</creator><creator>Joldersma, L</creator><creator>Bosch, J</creator><creator>Yusuf, S</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Long-term effect of rosiglitazone and/or ramipril on the incidence of diabetes</title><author>Gerstein, H C ; Mohan, V ; Avezum, A ; Bergenstal, R M ; Chiasson, J-L ; Garrido, M ; MacKinnon, I ; Rao, P V ; Zinman, B ; Jung, H ; Joldersma, L ; Bosch, J ; Yusuf, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-56f7f0bab4efe84f2b4c568ed4db510c8e793f668153f92354f203391e5eb9d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Diabetes</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - prevention & control</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Drug therapy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Fasting</topic><topic>Female</topic><topic>Glucose</topic><topic>Health sciences</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Plasma</topic><topic>Prevention</topic><topic>Ramipril - therapeutic use</topic><topic>Research centers</topic><topic>Thiazolidinediones - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerstein, H C</creatorcontrib><creatorcontrib>Mohan, V</creatorcontrib><creatorcontrib>Avezum, A</creatorcontrib><creatorcontrib>Bergenstal, R M</creatorcontrib><creatorcontrib>Chiasson, J-L</creatorcontrib><creatorcontrib>Garrido, M</creatorcontrib><creatorcontrib>MacKinnon, I</creatorcontrib><creatorcontrib>Rao, P V</creatorcontrib><creatorcontrib>Zinman, B</creatorcontrib><creatorcontrib>Jung, H</creatorcontrib><creatorcontrib>Joldersma, L</creatorcontrib><creatorcontrib>Bosch, J</creatorcontrib><creatorcontrib>Yusuf, S</creatorcontrib><creatorcontrib>DREAM On (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication Ongoing Follow-up) Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gerstein, H C</au><au>Mohan, V</au><au>Avezum, A</au><au>Bergenstal, R M</au><au>Chiasson, J-L</au><au>Garrido, M</au><au>MacKinnon, I</au><au>Rao, P V</au><au>Zinman, B</au><au>Jung, H</au><au>Joldersma, L</au><au>Bosch, J</au><au>Yusuf, S</au><aucorp>DREAM On (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication Ongoing Follow-up) Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term effect of rosiglitazone and/or ramipril on the incidence of diabetes</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>54</volume><issue>3</issue><spage>487</spage><epage>495</epage><pages>487-495</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract>Aims/hypothesis
The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial reported that 3 years of therapy with rosiglitazone reduced the primary outcome of diabetes or death by 60%. Here we investigated whether an effect on diabetes prevention persists more than 1.5 years after therapy has been discontinued.
Methods
The DREAM On passive follow-up study was conducted at 49 of the 191 DREAM sites. Consenting participants were invited to have a repeat OGTT 1–2 years after active therapy ended. A diagnosis of diabetes at that time was based on either a fasting or 2 h plasma glucose level of ≥7.0 mmol/l or ≥11.1 mmol/l, respectively, or a confirmed diagnosis by a non-study physician. Regression to normoglycaemia was defined as a fasting and 2 h plasma glucose level of <6.1 mmol/l and <7.8 mmol/l, respectively.
Results
After a median of 1.6 years after the end of the trial and 4.3 years after randomisation, rosiglitazone participants had a 39% lower incidence of the primary outcome (hazard ratio [HR] 0.61, 95% CI 0.53–0.70;
p
< 0.0001) and 17% more regression to normoglycaemia (95% CI 1.01–1.34;
p
= 0.034). When the analysis was restricted to the passive follow-up period, a similar incidence of both the primary outcome and regression was observed in people from both treatment groups (HR 1.00, 95% CI 0.81–1.24 and HR 1.14, 95% CI 0.97–1.32, respectively). Similar effects were noted when new diabetes was analysed separately from death. Ramipril did not have any significant long-term effect.
Conclusions/interpretation
Time-limited exposure to rosiglitazone reduces the longer term incidence of diabetes by delaying but not reversing the underlying disease process.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21116607</pmid><doi>10.1007/s00125-010-1985-4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetologia, 2011-03, Vol.54 (3), p.487-495 |
| issn | 0012-186X 1432-0428 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Biological and medical sciences Diabetes Diabetes Mellitus - drug therapy Diabetes Mellitus - prevention & control Diabetes. Impaired glucose tolerance Drug therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Fasting Female Glucose Health sciences Human Physiology Humans Hypoglycemic Agents - therapeutic use Internal Medicine Male Medical research Medical sciences Medicine Medicine & Public Health Metabolic Diseases Middle Aged Plasma Prevention Ramipril - therapeutic use Research centers Thiazolidinediones - therapeutic use |
| title | Long-term effect of rosiglitazone and/or ramipril on the incidence of diabetes |
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