Diabetes Prevention Program (dpp)
The Diabetes Prevention Program (DPP) was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in study participants. At the beginning of the DPP, participants were all overweight and had blood glucose, also called blood sugar, levels higher than normal but not high enough for a diagnosis of diabetes - a condition called prediabetes. The DPP found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes. Taking metformin also reduced risk, although less dramatically. The DPP resolved its research questions earlier than projected and, following the recommendation of an external monitoring board, the study was halted a year early. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine . In the DPP, participants from 27 clinical centers around the United States were randomly divided into different treatment groups. The first group, called the lifestyle intervention group, received intensive training in diet, physical activity, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7 percent of their body weight and maintain that loss. The second group took 850 mg of metformin twice a day. The third group received placebo pills instead of metformin. The metformin and placebo groups also received information about diet and exercise but no intensive motivational counseling. A fourth group was treated with the drug troglitazone (Rezu Continue reading >>
Questions & Answers About The Diabetes Prevention Program Outcomes Study
Questions & Answers about the Diabetes Prevention Program Outcomes Study Questions & Answers about the Diabetes Prevention Program Outcomes Study Questions & Answers about the Diabetes Prevention Program Outcomes Study What is the Diabetes Prevention Program (DPP)? The DPP was a randomized, controlled clinical trial that determined if certain interventions could prevent or delay type 2 diabetes in adults at high risk for developing the disease. The multicenter study enrolled 3,234 overweight participants with blood glucose levels that were higher than normal but not yet in the diabetic range. Forty-five percent of participants were from minority groups disproportionately affected by type 2 diabetes: African Americans, Hispanic Americans, Asian Americans and Pacific Islanders, and American Indians. The trial also recruited other groups at higher risk for type 2 diabetes, including individuals age 60 and older, women with a history of gestational diabetes, and people who have a first-degree relative with type 2 diabetes. What interventions were tested in the DPP? Participants were randomly assigned to one of the following approaches: Intensive lifestyle changes with the aim of reducing weight by 7 percent through a low-fat diet and increased physical activity. Participants were asked to maintain physical activity at least 150 minutes a week with moderate exercise, such as walking or biking. Standard advice on diet and exercise plus treatment with the drug metformin (850 mg twice a day), approved in 1995 to treat type 2 diabetes. Standard advice on diet and exercise plus placebo pills in place of metformin. A fourth arm of the study, treatment with the drug troglitazone (Rezulin) combined with standard diet and exercise recommendations, was discontinued in June 1998 due t Continue reading >>
Diabetes Prevention Program Outcomes Study (dppos) Highlights
74th Scientific Sessions of the American Diabetes Association (ADA): Diabetes Prevention Program Outcomes Study (DPPOS) Highlights EndocrineWeb.com summarizes some of the results of the Diabetes Prevention Program Outcomes Study (DPPOS) featured during the American Diabetes Associations 74th Scientific Sessions held at the Moscone Center June 13-17, 2014 in San Francisco. The DPPOS data is timely, as the Centers for Disease Control and Prevention (CDC) just revealed that 29 million people in the United States (US) have diabetes. Approximately, 28 million of those individuals have Type 2 Diabetes (T2D). The incidence of new T2D cases per annum amounts to 1.7 million. Furthermore, the CDCs report indicates that 86 million people in the US are prediabetic and at increased risk for developing T2D over time. The Diabetes Prevention Program was a multicenter trial with 27 centers in the US. The DPP was designed to determine whether the development of diabetes could be prevented or delayed in persons of high-risk and very high risk, stated David M. Nathan, MD, Chairman of the DPP/DPPOS and Professor of Medicine at Harvard Medical School in Boston. At baseline, each volunteers glucose levels were elevated (prediabetes), and they all were overweight or obese. The study population represented racial, ethnic and age groups often affected by T2D. Lifestyle intervention group: behavioral modification aimed at reducing weight by 7%. Active treatment group: metformin was used to prevent diabetes, not treat it. The DPPOS, in follow-up to the DPP, was designed to determine if the development of diabetes demonstrated in the DPP studywhich was delayed over a brief time period would continue to be delayed or prevented over a longer time period, as well as the health and economic implicati Continue reading >>
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Metformin For Diabetes Prevention: Insights Gained From The Diabetes Prevention Program/diabetes Prevention Program Outcomes Study
Abstract The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (1996–2001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n = 1082) or metformin (n = 1073) 850 mg twice daily, or intensive lifestyle intervention (n = 1079). The masked metformin/placebo intervention phase ended approximately 1 year ahead of schedule because of demonstrated efficacy. Primary outcome was reported at 2.8 years. At the end of the DPP, all participants were offered lifestyle education and 88% (n = 2776) of the surviving DPP cohort continued follow-up in the DPPOS. Participants originally assigned to metformin continued to receive metformin, unmasked. The DPP/DPPOS cohort has now been followed for over 15 years with prospective assessment of glycaemic, cardiometabolic, health economic and safety outcomes. After an average follow-up of 2.8 years, metformin reduced the incidence of diabetes by 31% compared with placebo, with a greater effect in those who were more obese, had a higher fasting glucose or a history of gestational diabetes. The DPPOS addressed the longer-term effects of metformin, showing a risk reduction of 18% over 10 and 15 years post-randomisation. Metformin treatment for diabetes prevention was estimated to be cost-saving. At 15 years, lack of progression to diabetes was associated with a 28% lower risk of microvascular complications across treatment Continue reading >>
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Metformin For Diabetes Prevention: Insights Gained From The Diabetes Prevention Program/diabetes Prevention Program Outcomes Study
AU - for the Diabetes Prevention Program Research Group N2 - The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (19962001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n=1082) or metformin (n=1073) 850mg twice daily, or intensive lifestyle intervention (n=1079). The masked metformin/placebo intervention phase ended approximately 1 year ahead of schedule because of demonstrated efficacy. Primary outcome was reported at 2.8 years. At the end of the DPP, all participants were offered lifestyle education and 88% (n=2776) of the surviving DPP cohort continued follow-up in the DPPOS. Participants originally assigned to metformin continued to receive metformin, unmasked. The DPP/DPPOS cohort has now been followed for over 15years with prospective assessment of glycaemic, cardiometabolic, health economic and safety outcomes. After an average follow-up of 2.8years, metformin reduced the incidence of diabetes by 31% compared with placebo, with a greater effect in those who were more obese, had a higher fasting glucose or a history of gestational diabetes. The DPPOS addressed the longer-term effects of metformin, showing a risk reduction of 18% over 10 and 15years post-randomisation. Metformin treatment for diabetes prevention was estimated to be cost-saving. At 15years, lack of progression to diabetes was associated with a 28% lower risk of microva Continue reading >>
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- Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
10-year Follow-up Of Diabetes Incidence And Weight Loss In The Diabetes Prevention Program Outcomes Study - Sciencedirect
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study Author links open overlay panel Diabetes Prevention Program Research Group In the 28 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term. All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 57 years (IQR 5558). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov , number NCT00038727 . During the 100-year (IQR 90105) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 48 cases per 100 person-years (95% CI 4157) in the intensive lifestyle intervention group, 78 (6888) in the metformin group, and 110 (98123) in the placebo group. Diabetes incidence rates in this follow-up study were similar be Continue reading >>
The Cost-effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study
The cost-effectiveness of diabetes prevention: results from the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study Clinical Diabetes and Endocrinology20151:9 The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58% with lifestyle intervention and 31% with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34% in the lifestyle group and 18% in the metformin group compared to placebo. The purpose of this article is to review and synthesize analyses published by the DPP/DPPOS Research Group that have described the cost-effectiveness of diabetes prevention. We describe the resource utilization and costs of the DPP and DPPOS interventions, the costs of non-intervention-related medical care, the impact of the interventions on diabetes progression and quality-of-life, and the cost-effectiveness of the interventions from health system and societal perspectives. Cost-effectiveness analyses were performed with a 3-year time horizon using DPP data, a lifetime time horizon that simulated 3-year DPP data, and a 10-year time horizon using combined DPP/DPPOS data. Although more expensive than the placebo intervention, the greater costs of the lifestyle and metformin interventions were offset by reductions in the costs of no Continue reading >>
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08/22 Diabetes Prevention Program Outcomes Study (dppos) Phase 3 - Research Project Kahn, Steven Emanuel Seattle Institute For Biomedical/clinical Research, Seattle, Wa, United States
08/22 Diabetes Prevention Program Outcomes Study (DPPOS) Phase 3 - Research Project Abnormal regulation of glycemia (dysglycemia) has a very long time course, from its earliest stage, labeled pre-diabetes, to the onset of Type 2 diabetes (T2D), to the development of clinically detectable microvascular changes and measurable atherosclerosis, to clinically manifest complications with attendant morbidity and mortality. The Diabetes Prevention Program (DPP) focused on the pre-diabetes stage of dysglycemia and demonstrated powerful beneficial effects of lifestyle intervention (ILS) and metformin (MET), compared with placebo (PLBO), in preventing or delaying the onset of T2D over a 3-year period in a high-risk population (n=3234). The DPP also investigated and described the interventions, phenotypic and genotypic risk factors associated with T2D development, the effects of the interventions in the setting of these risk factors, the health economic implications of T2D prevention, and other outcomes of interest. Based on these results, the DPP lifestyle program has been widely implemented. The 11-year follow-up DPP Outcomes Study (DPPOS) explored the longer-term effects of T2D prevention, bridging the period between pre-diabetes and T2D, and examined outcomes that required more time to develop than the relatively brief 3-years of DPP. DPPOS showed longer-term salutary effects of the original interventions on T2D prevention and on cardiovascular disease (CVD) risk factors. Prevention was cost-saving with MET and cost-effective with ILS. Overall, the risk for microvascular disease was significantly greater in subjects who developed T2D and increased with longer duration and higher hemoglobin A1c (A1C). There were no significant differences by treatment group in the prevalence of Continue reading >>
- Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study
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15/22 Diabetes Prevention Program Outcomes Study (dppos) Phase 3 - Research Project
15/22 Diabetes Prevention Program Outcomes Study (DPPOS) Phase 3 - Research Project 15/22 Diabetes Prevention Program Outcomes Study (DPPOS) Phase 3 - Research Project Abnormal regulation of glycemia ("dysglycemia") has a very long time course, from its earliest stage, labeled pre-diabetes, to the onset of Type 2 diabetes (T2D), to the development of clinically detectable microvascular changes and measurable atherosclerosis, to clinically manifest complications with attendant morbidity and mortality. The Diabetes Prevention Program (DPP) focused on the pre-diabetes stage of dysglycemia and demonstrated powerful beneficial effects of lifestyle intervention (ILS) and metformin (MET), compared with placebo (PLBO), in preventing or delaying the onset of T2D over a 3-year period in a high-risk population (n=3234). The DPP also investigated and described the interventions, phenotypic and genotypic risk factors associated with T2D development, the effects of the interventions in the setting of these risk factors, the health economic implications of T2D prevention, and other outcomes of interest. Based on these results, the DPP lifestyle program has been widely implemented. The 11-year follow-up DPP Outcomes Study (DPPOS) explored the longer-term effects of T2D prevention, bridging the period between pre-diabetes and T2D, and examined outcomes that required more time to develop than the relatively brief 3-years of DPP. DPPOS showed longer-term salutary effects of the original interventions on T2D prevention and on cardiovascular disease (CVD) risk factors. Prevention was cost-saving with MET and cost-effective with ILS. Overall, the risk for microvascular disease was significantly greater in subjects who developed T2D and increased with longer duration and higher hemoglobin A1 Continue reading >>
- Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study
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Metformin, Lifestyle Intervention, And Cognition In The Diabetes Prevention Program Outcomes Study
Luchsinger, J. A., Ma, Y., Christophi, C. A. , Florez, H. , Golden, S. H., Hazuda, H., ... for the Diabetes Prevention Program Research Group (2017). Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes study . Diabetes Care , 40(7), 958-965. DOI: 10.2337/dc16-2376 Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes study. / Luchsinger, Jos A.; Ma, Yong; Christophi, Costas A. ; Florez, Hermes ; Golden, Sherita H.; Hazuda, Helen; Crandall, Jill; Venditti, Elizabeth; Watson, Karol; Jeffries, Susan; Manly, Jennifer J.; Pi-Sunyer, F. Xavier; for the Diabetes Prevention Program Research Group. In: Diabetes Care , Vol. 40, No. 7, 01.07.2017, p. 958-965. Research output: Contribution to journal Article Luchsinger, JA, Ma, Y, Christophi, CA , Florez, H , Golden, SH, Hazuda, H, Crandall, J, Venditti, E, Watson, K, Jeffries, S, Manly, JJ, Pi-Sunyer, FX & for the Diabetes Prevention Program Research Group 2017, ' Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes study ' Diabetes Care , vol 40, no. 7, pp. 958-965. DOI: 10.2337/dc16-2376 Luchsinger JA, Ma Y, Christophi CA , Florez H , Golden SH, Hazuda H et al. Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes study . Diabetes Care . 2017 Jul 1;40(7):958-965. Available from, DOI: 10.2337/dc16-2376 Luchsinger, Jos A. ; Ma, Yong ; Christophi, Costas A. ; Florez, Hermes ; Golden, Sherita H. ; Hazuda, Helen ; Crandall, Jill ; Venditti, Elizabeth ; Watson, Karol ; Jeffries, Susan ; Manly, Jennifer J. ; Pi-Sunyer, F. Xavier ; for the Diabetes Prevention Program Research Group. / Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes stu Continue reading >>
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Diabetes Prevention Program Outcomes Study
Diabetes Prevention Program Outcomes Study The George Washington University Biostatistics Center proposes to continue as the Coordinating Center for the Diabetes Prevention Program Outcomes Study (DPPOS). This application is companion to the Clinical Centers' application. The Diabetes Prevention Program (DPP), a multi-center controlled clinical trial in a multiracial population of overweight persons with impaired glucose tolerance, established the efficacy of a life-style intervention aimed at a modest degree of weight loss and increased moderate-intensity activity, and of metformin in decreasing the development of diabetes by 58 and 31%, respectively. The DPPOS, a 10- year follow-up, was funded in 2002 for a five-year period with the understanding that it would require refunding via competitive renewal. The overarching goal of DPPOS was to study whether the relatively shortterm benefits of delaying diabetes demonstrated in the DPP would translate into a more long-lasting impact that would reduce the public health burden of the diabetes epidemic. Specifically, DPPOS had the following major goals: 1) to determine the effects of DPP interventions on the long-term microvascular and cardiovascular disease (CVD) complications, atherosclerosis and CVD risk factors; 2) to examine the long-term effects and durability of prior DPP interventions on further diabetes development; and 3) to describe the incidence of long-term complications and their risk factors in new onset type 2 diabetes and IGT. To date, after 10 years of DPP/DPPOS, 93% of the DPPOS cohort attends annual follow-up visits. A durable effect of diabetes prevention associated with the life-style and metformin interventions has been demonstrated with 36 and 19% reductions in diabetes incidence, respectively, compare Continue reading >>
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Diabetes Prevention Program Maintains Benefit 10 Years Later
Diabetes Prevention Program Maintains Benefit 10 Years Later More than 10 years after a lifestyle intervention program to prevent type 2 diabetes showed dramatic results, researchers have found the benefits are long-lasting. The findings should encourage primary care physicians to get patients involved in these types of programs, lead author Bonny Rockette-Wagner, PhD, from the Department of Epidemiology at the University of Pittsburgh in Pennsylvania, told Medscape Medical News. Lifestyle intervention was one group in the Diabetes Prevention Program (DPP) landmark trial, which concluded in 2000. Participants in the other groups received metformin or placebo. The lifestyle intervention had two main goals: a 7% maintained weight loss and 150 minutes per week of moderate to vigorous physical activity (MVPA) at the intensity of a brisk walk. The intervention featured several components including lifestyle coaches, trained through a national network, who kept in frequent contact with participants to help them maintain their goals; supervised physical activity sessions; and adherence strategies tailored to individual participants. After the DPP trial demonstrated a 58% decrease in diabetes incidence among participants in the lifestyle intervention group compared with placebo, participants from all three study groups were offered a group version of the lifestyle intervention. Those who accepted were followed in the DPP Outcomes Study (DPPOS) for more than 10 years from the DPP trial baseline. In the current study, Dr Rockette-Wagner and colleagues used accelerometer data to objectively measure whether the increased physical activity seen among DDPOS participants was sustained long-term. They published their findings online November 21 in the American Journal of Preventive Me Continue reading >>
The 10-year Cost-effectiveness Of Lifestyle Intervention Or Metformin For Diabetes Prevention
OBJECTIVE The Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS) demonstrated that either intensive lifestyle intervention or metformin could prevent type 2 diabetes in high-risk adults for at least 10 years after randomization. We report the 10-year within-trial cost-effectiveness of the interventions. RESEARCH DESIGN AND METHODS Data on resource utilization, cost, and quality of life were collected prospectively. Economic analyses were performed from health system and societal perspectives. RESULTS Over 10 years, the cumulative, undiscounted per capita direct medical costs of the interventions, as implemented during the DPP, were greater for lifestyle ($4,572) than metformin ($2,281) or placebo ($752). The cumulative direct medical costs of care outside the DPP/DPPOS were least for lifestyle ($26,810 lifestyle vs. $27,384 metformin vs. $29,007 placebo). The cumulative, combined total direct medical costs were greatest for lifestyle and least for metformin ($31,382 lifestyle vs. $29,665 metformin vs. $29,759 placebo). The cumulative quality-adjusted life-years (QALYs) accrued over 10 years were greater for lifestyle (6.89) than metformin (6.79) or placebo (6.74). When costs and outcomes were discounted at 3% and adjusted for survival, lifestyle cost $12,878 per QALY, and metformin had slightly lower costs and nearly the same QALYs as placebo. CONCLUSIONS Over 10 years, from a payer perspective, lifestyle was cost-effective and metformin was marginally cost-saving compared with placebo. Investment in lifestyle and metformin interventions for diabetes prevention in high-risk adults provides good value for the money spent. Intensive lifestyle and metformin interventions can delay or prevent progression from impaired glucose tolerance (IGT) to type 2 diabetes Continue reading >>
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Long-term Metformin Use And Vitamin B12 Deficiency In The Diabetes Prevention Program Outcomes Study
Secondary analysis from the DPP/DPPOS. Participants were assigned to the placebo group (PLA) (n = 1082) or the metformin group (MET) (n = 1073) for 3.2 years; subjects in the metformin group received open-label metformin for an additional 9 years. DPP eligibility criteria were: elevated fasting glucose, impaired glucose tolerance, and overweight/obesity. The analytic population comprised participants with available stored samples. B12 levels were assessed at 5 years (n = 857, n = 858) and 13 years (n = 756, n = 764) in PLA and MET, respectively. Low B12 (≤ 203 pg/mL) occurred more often in MET than PLA at 5 years (4.3 vs 2.3%; P = .02) but not at 13 years (7.4 vs 5.4%; P = .12). Combined low and borderline-low B12 (≤ 298 pg/mL) was more common in MET at 5 years (19.1 vs 9.5%; P < .01) and 13 years (20.3 vs 15.6%; P = .02). Years of metformin use were associated with increased risk of B12 deficiency (odds ratio, B12 deficiency/year metformin use, 1.13; 95% confidence interval, 1.06–1.20). Anemia prevalence was higher in MET, but did not differ by B12 status. Neuropathy prevalence was higher in MET with low B12 levels. All parameters decreased to their respective nadir at 1 month and then gradually returned toward baseline values. White blood cells (WBCs) and platelets (PLTs) were the most significantly affected cells. At 1 month, the decrease was 29.6% (P < .0001) for WBCs and 25% (P < .0001) for PLTs, whereas at 12 months, the decrease was 15.5% (P < .0001) and 13% (P < .0001), respectively. Lymphocytes appeared to be more susceptible to I-131 than neutrophils (ANCs). The decreases were small in absolute numbers for red blood cells, hematocrit and hemoglobin not surpassing 10%. Multivariate analysis demonstrated that the ratio of administered prescribed activity-t Continue reading >>
Diabetes Prevention Program Outcomes Study (dppos)
Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information The Diabetes Prevention Program (DPP) was a multi-center trial examining the ability of an intensive lifestyle or metformin to prevent or delay the development of diabetes in a high risk population due to the presence of impaired glucose tolerance (IGT). The DPP has ended early demonstrating that lifestyle reduced diabetes onset by 58% and metformin reduced diabetes onset by 31%. DPPOS (2002-2013) is designed to take advantage of the scientifically and clinically valuable DPP participants. This group of participants is nearly 50% minority and represents the largest IFG/IGT population ever studied. Clinically important research questions remain that focus on 1) durability of the prior DPP intervention, 2) determination of the clinical course of precisely known new onset diabetes, in particular regarding microvascular disease, CVD risk factors and atherosclerosis, 3) close examination of these topics in men vs women and in minority populations. The major aims of DPPOS-3 (2014-2025) take advantage of the long-term randomized exposure of the study cohort to metformin and the aging of the DPPOS cohort. The metformin exposure and high degree of study retention and adherence (~85% of the DPPOS cohort continues to attend annual and mid-year visits) allows DPPOS-3 to examine the long-term effects of metformin on cardiovascular disease (CVD) and cancer outcomes, outcomes of great clinical interest and import. Diabetes Prevention Program Outcomes Study randomized to unmasked Intensive Lifestyle during the DPP and offered Intensive Lifestyle Group Session, DPPOS Group Lifestyle plus DPPOS Boost Lifestyle sessions in DPPOS Phase 1 and 2 In addition to Continue reading >>
- Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
- A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC’s National Diabetes Prevention Program
