According to Dr Sidney M. Wolfe of the US Public Citizen's Health Research Group, and author of Worst Pills, Best Pills (Washington, DC: Public Citizen's Health Research Group, 1993), "Doctors find it easier to prescribe a pill than to nag patients with type 2 diabetes to lose weight the safest way to treat the condition."

Consequently, many patients with type 2 diabetes, which could easily be controlled by changes in lifestyle, are turning to pills (called oral hypoglycaemics) with side effects that are even worse than having the disease itself. Indeed, according to Diabetes UK (formerly the British Diabetic Association), around 50 per cent of type 2 diabetics take diabetic pills or roughly 525,000 individuals in the UK alone.

Type 2 diabetes (also known as non insulin dependent or adult onset diabetes) usually appears in individuals between 40 and 75 years of age. The condition develops when the body is still able to produce insulin, though not enough for its needs.

Insulin is a vital protein hormone secreted by the islet cells of the pancreas and serves as a signal of the fed state. It is secreted in response to elevated blood levels of glucose and proteins.

The condition may be hereditary and only reveal itself when sufferers become overweight. It tends to be more common in Asian and African Caribbean communities. It can also be triggered by excessive eating and drinking.

People are now eating more and exercising less on both sides of the Atlantic. The proportion of American adults between the ages of 20 and 74 years with a body mass index greater than 30 kg/m2 increased from 12á3 per cent during 1976-1980 to 22á5 per cent during 1988-1994 (Int J Obes Relat Metab Disord, 2000; 22: 39-47). In the UK, this proportion rose from 6 per cent to 16 per cent in men and from 8 per cent to 17á3 per cent in women between 1980 and 1996 (Prescott-Clark P, Primatesta P. Health Survey for England, London: Her Majesty's Stationery Office, 1996).

Perhaps not surprisingly then, according to Diabetes UK, around 1.4 million people in the UK are now thought to be diabetic, of whom three quarters have the type 2 version of the condition.

According to the American Diabetes Association (ADA), nearly 16 million Americans have diabetes, and at least 90 per cent of those over the age of 20 are non insulin dependent (American Diabetes Association, Complete Guide to Diabetes, Alexandria, VA: ADA, 1996: 7).

According to leading nutritionist Dr Stephen Davies, planning your meals properly and getting regular exercise can help your body maintain healthy blood sugar levels (Lancet, 1991; 338: 774-8). If you're overweight, losing weight will help your body use insulin better. Sometimes, losing just 10 or 20 pounds (about half a stone to one and a half stone) is enough to bring diabetes under control. Bringing your blood pressure down is also helpful. Ways to do this include ingesting less salt, and avoiding alcohol and smoking.

So, diet appears to be the safest and most effective way to treat type 2 diabetes. In this case, why do we need to take pills which have such a disturbing array of side effects particularly when there is, as yet, no conclusive evidence that improved glucose control with the use of oral drugs will decrease the risk of complications of type 2 diabetes (Therap Lett, 1998; issue 23, Jan-Mar)?