It seems dozens of pills and potions are available every day, for a variety of diseases, conditions, and symptoms. Sometimes these medications seem like miracles. But to many health professionals, this boom in pharmaceutical cornucopia spells big trouble. Are we substituting medicine for good health practices?

One hint that early drug treatment may offer little real protection comes from the discovery there was no statistically significant difference in cardiovascular events between the two groups.

Another huge question: Suppose instead of taking a drug, you worked hard on exercise, diet and lifestyle? In the fine print, the DREAM team admits the size of the effect seen with rosiglitazone was about the same as the effect of lifestyle changes in other studies.

How would we conduct this study if we cared about science, instead of selling rosiglitazone? We'd compare rosiglitazone directly with a cheaper generic drug such as metformin, to see if it was better and by how much.

We'd work harder to find out how much of the improvement attributed to the drugs could have been matched with exercise only.

And we'd wait longer to see the long-term health outcomes.