Effect And Maintenance Of The Slimmer Diabetes Prevention Lifestyle Intervention In Dutch Primary Healthcare: A Randomised Controlled Trial
Original Article | Open Effect and maintenance of the SLIMMER diabetes prevention lifestyle intervention in Dutch primary healthcare: a randomised controlled trial Nutrition & Diabetes volume 7, page e268 (2017) To assess the effectiveness of the SLIMMER combined dietary and physical activity lifestyle intervention on clinical and metabolic risk factors, dietary intake, physical activity, and quality of life after 12 months, and to investigate whether effects sustained six months after the active intervention period ended. SLIMMER was a randomised controlled intervention, implemented in Dutch primary healthcare. In total, 316 subjects aged 4070 years with increased risk of type 2 diabetes were randomly allocated to the intervention group (10-month dietary and physical activity programme) or the control group (usual healthcare). All subjects underwent an oral glucose tolerance test and physical examination, and filled in questionnaires. Identical examinations were performed at baseline and after 12 and 18 months. Primary outcome was fasting insulin. The intervention group showed significantly greater improvements in anthropometry and glucose metabolism. After 12 and 18 months, differences between intervention and control group were -2.7 kg (95% confidence interval (CI): 3.7; 1.7) and 2.5 kg (95% CI: 3.6; 1.4) for weight, and 12.1 pmol l1 (95% CI: 19.6; 4.6) and 8.0 pmol l1 (95% CI: 14.7; 0.53) for fasting insulin. Furthermore, dietary intake, physical activity, and quality of life improved significantly more in the intervention group than in the control group. The Dutch SLIMMER lifestyle intervention is effective in the short and long term in improving clinical and metabolic risk factors, dietary intake, physical activity, and quality of life in subjects at high risk of Continue reading >>
- The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Glibenclamide and metfoRmin versus stAndard care in gEstational diabeteS (GRACES): a feasibility open label randomised trial
10-year Follow-up Of Diabetes Incidence And Weight Loss In The Diabetes Prevention Program Outcomes Study.
Lancet. 2009 Nov 14;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4. Epub 2009 Oct 29. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. In the 2.8 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 5.7 years (IQR 5.5-5.8). 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 10.0-year (IQR 9.0-10.5) 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 4.8 cases per 100 person-years (95% CI 4.1-5.7) in the intensive lifestyle intervention group, 7.8 (6.8-8.8) in the metformin group, and 11.0 (9.8-12.3) in the placebo group. Diabetes incidence rates Continue reading >>
Re: Time To Question The Nhs Diabetes Prevention Programme
Re: Time to question the NHS diabetes prevention programme Time to question the NHS diabetes prevention programme BMJ 2015; 351 doi: (Published 07 September 2015) Cite this as: BMJ 2015;351:h4717 Re: Time to question the NHS diabetes prevention programme The NHS Diabetes Prevention Programme (NHS DPP) has the potential to provide valuable evidence on the real-world effectiveness of such programmes (1). Yet the concept of 'diabetes prevention' is being pitched as if diabetes were an event - similar to 'stroke prevention.' Measures of glycaemia, whether fasting or 2h post-load plasma glucose (FPG, 2hPG), or HbA1c are continuous variables with cut-points for 'pre diabetes' and diabetes. The 10 year (2) and 15 year follow-up (3) of the largest and most rigorous prevention study, the Diabetes Prevention Program (4) have provided some valuable lessons which might usefully inform the NHS DPP, and help contextualise the expectations. For clarity I will refer to this as the US-DPP. - Firstly, all US-DPP recruits had impaired glucose tolerance (IGT) (4), as did nearly 80% of subjects in a recent meta-analysis of diabetes prevention studies (5). Only one study has explored the effects of lifestyle interventions on people with impaired fasting glucose (IFG), and has not found a significant benefit (6). As yet, there are no studies on people with HbA1c-classified 'pre diabetes.' - Secondly, the measures of glycaemia in US-DPP subjects deteriorated progressively with time. So the intensive lifestyle intervention, aiming for 7% weight loss and 150 minutes per week of physical activity in a highly selected group of subjects achieved a delay in the diagnosis of diabetes by 3-4 years, and a mean reduction in levels of HbA1c of 0.12% during the 10y follow-up (2). - Thirdly, after 15 year Continue reading >>
- Get off your backside! It's madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is exercise, says DR MICHAEL MOSLEY, who reversed HIS own diabetes
- Type 2 diabetes can be REVERSED by strict weight loss programme without medication, study finds
- Diabetes programme ‘changing my life’
The National Diabetes Prevention Program (ndpp)
The National Diabetes Prevention Program (NDPP) - The Daily Prediabaid The National Diabetes Prevention Program (NDPP) In 1997, the Federal health authorities launcher a major multicenter clinical researchstudy aimed at discovering whether modestweight loss through dietary changes andincreased physical activity or treatment withthe most common oral diabetes drug could prevent or delay the onset of type 2 diabetes in study participants. These participants already displayed impared glucose tolerance, aka prediabetes symptoms. The results ,published in the February 7, 2002, issue of the New England Journal of Medicine,showed that people with prediabetes who lose 5% to 7% of their body weight through healthier eating and 150 minutes of physical activity a week can cut their risk of developing type 2 diabetes by 58% (71% for people over 60 years old). And, as the DiabetesPrevention Program Outcomes Study(DPPOS), the follow-up to the DPP, revealed, the impact of such a lifestyle change program is lasting. Even after 10 years, people who completed a diabetes prevention program remain one third less likely to develop type 2 diabetes. As a result, the National Diabetes Prevention Program (or National DPP) was born as a partnership of public and private organizations working hand in hand to reduce the growing problem of prediabetes and type 2 diabetes. The goal is to make it easier for people with prediabetes to participate in evidence-based, affordable, and high-quality lifestyle change programs to reduce their risk of type 2 diabetes and improve their overall health. 1 Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.N Engl J Med 2002; 346:393-403February 7, 2002DOI: 10.1056/NEJMoa012512 2 Diabet Continue reading >>
10-year Follow-up Of Diabetes Incidence And Weight Loss In The Diabetes Prevention Program Outcomes Study
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study Diabetes Prevention Program Research Group * Correspondence to: Diabetes Prevention Program Coordinating Center, Biostatistics Center, George Washington University, 6110 Executive Boulevard, Suite 750, Rockville, MD 20852, USA, [email protected] The publisher's final edited version of this article is available at Lancet This article has been corrected. See the correction in volume 374 onpage2054. See other articles in PMC that cite the published article. 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 {"type":"clinical-trial","attrs":{"text":"NCT00038727","term_id":"NCT00038727"}}N Continue reading >>
Pedro - Search Detailed Search Results
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study Diabetes Prevention Program Research Group 7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* BACKGROUND: In the 2.8 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. METHODS: All active DPP participants were eligible for continued follow-up. 2,766 of 3,150 (88%) enrolled for a median additional follow-up of 5.7 years (IQR 5.5 to 5.8). 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. FINDINGS: During the 10.0-year (IQR 9.0 to 10.5) follow-up Continue reading >>
Sisa - Societ Italiana Per Lo Studio Dell'aterosclerosi - 10-year Follow-up Of Diabetes Incidence And Weight Loss In The Diabetes Prevention Program Outcomes Study
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM. BACKGROUND: In the 2.8 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. METHODS: All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5.7 years (IQR 5.5-5.8). 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. FINDINGS: During the 10.0-year (IQR 9.0-10.5) 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 4.8 cases per 100 person-years (95% CI 4.1-5.7) in the intensive lifestyle intervention group Continue reading >>
Prevention Of Type 2 Diabetes: Evidence And Strategies
Prevention of Type 2 Diabetes: Evidence and Strategies Journal of Clinical Outcomes Management. 2017 April;24(4) 1. International Diabetes Federation. Diabetes facts and figures. www.idf.org/about-diabetes/facts-figures . Accessed on January 29, 2017. 2. Centers for Disease Control and Prevention. National diabetes statistics report, 2014. www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf . Accessed on January 29, 2017. 3. Centers for Disease Control and Prevention. Number of Americans with diabetes projected to double or triple by 2050. www.cdc.gov/media/pressrel/2010/r101022.html . Accessed on January 29, 2017. 4. World Health Organization (WHO). Diabetes fact sheet. No. 312. November 2016. www.who.int/mediacentre/factsheets/fs312/en/ . Accessed on January 29, 2017. 5. Karam JG, McFarlane SI. Update on the prevention of type 2 diabetes. Curr Diab Rep 2011;11:5663. 6. Menke A, Rust KF, Fradkin J, et al. Associations between trends in race/ethnicity, aging, and body mass index with diabetes prevalence in the United States: a series of cross-sectional studies. Ann Intern Med 2014;161:32885. 7. Ford ES, Li C, Sattar N . Metabolic syndrome and incident diabetes: current state of the evidence. Diabetes Care 2008;31:1898904. 8. American Diabetes Association. Standards of medical care in diabetes2017. Diabetes Care 2017;40(Suppl. 1). 9. Kruszynska YT, Olefsky JM. Cellular and molecular mechanisms of non-insulin dependent diabetes mellitus. J Investig Med 1996;44:41328.. 10. Butler AE, Janson J, Bonner-Weir S, et al. Beta-cell deficit and increased beta-cell apoptosis in humans with type 2 diabetes. Diabetes 2003;52:10210. 11. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Report of a WHO and IDF Consultation. 2006. 43588/ Continue reading >>
- Can type 2 diabetes be reversed? Strategies, goals, and evidence
- The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies
- The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities
Lifestyle Intervention Can Prevent Diabetes Onset For At Least A Decade
Lifestyle Intervention Can Prevent Diabetes Onset for at Least a Decade Bruce Soloway, MD reviewing Diabetes Prevention Program Research Group. Lancet 2009 Nov 14. Lifestyle changes slowed development of diabetes in a large cohort study. In 2002, the Diabetes Prevention Program (DPP) reported that, compared with placebo, intensive lifestyle intervention or metformin in 3200 overweight adults with impaired glucose metabolism lowered the incidence of diabetes during 3 years by 58% and 31%, respectively ( JW Gen Med Feb 19 2002 ). To determine the long-term effects of these interventions, the researchers enrolled most patients who had completed the DPP into the 6-year unblinded DPP Outcomes Study (DPPOS). During a 1-year bridge period, all patients were offered a 16-session lifestyle curriculum, similar to that used in the DPP. All patients then received quarterly lifestyle-reinforcement sessions. Patients initially randomized to lifestyle intervention received eight additional lifestyle support sessions annually, and those initially randomized to metformin continued to receive twice-daily open-label metformin. During the 6-year DPPOS follow-up, the incidence of newly diagnosed diabetes was similar in all three groups. No rebound occurred in diabetes incidence in the lifestyle and metformin groups during follow-up rather, extension of the lifestyle intervention to metformin and placebo recipients seemed to lower incident diabetes in those groups. The net relative reduction in diabetes incidence during the full 10 years was 34% in the lifestyle group and 18% in the metformin group compared with the placebo group. All three groups recorded small mean weight losses (12.5 kg) during 10 years. This study demonstrates that lifestyle interventions can lower diabetes incidence fo Continue reading >>
10-year Follow-up Of Diabetes Incidence And Weight Loss In The Diabetes Prevention Program Outcomes Study.
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Recommended by Kyong Soo Park and Soo Heon Kwak From these 10-year follow-up results of the Diabetes Prevention Program Outcome Study (DPPOS), it is now more evident that (1) weight reduction is the major method of preventing type 2 diabetes and (2) life style interventions are a practical way to achieve sustained and effective weight loss. Intensive life style modifications using diet and exercise for about 3 years were able to prevent/delay diabetes for as long as 10 years.... To read the rest of this recommendation and access over 145,000 article recommendations from 3,700+ journals across biomedicine, register Send a recommendation to your institution's librarian or information manager to request an extended free trial for articles in biology and medicine, contributed inclusion in F1000Prime to help you filter recommendations, plus relevant articles as engine clusters of related articles and be alerted as soon as similar articles appear in If you think you should be able to access this content, please contact us . If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not recognised, please try again We are unable to reset your password, please contact [email protected] to reactivate your account, quoting error code UACC/DEL You registered with F1000 via Google, so we cannot reset your password. If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. If you still need help with your Facebook account pas Continue reading >>
Prevention Of Diabetes: How Far Have We Gone? Ramachandran A, Snehalatha C - Indian J Endocr Metab
Ramachandran A, Snehalatha C. Prevention of diabetes: How far have we gone?. Indian J Endocr Metab 2014;18:252-3 Ramachandran A, Snehalatha C. Prevention of diabetes: How far have we gone?. Indian J Endocr Metab [serial online] 2014 [cited2018 Apr 3];18:252-3. Available from: Diabetes is ubiquitous, its prevalence is rising globally, and the social and economic burden caused is very huge. The highest healthcare and economic burden is on the developing countries which lodge more than 80% of the persons affected with the disease. [1] Optimal management of diabetes is of utmost importance to reduce the morbidity and mortality resulting from the disease and its associated vascular complications. The rising incidence of diabetes calls for urgent action to prevent the occurrence of new cases, that is, primary prevention is a major strategy to be adopted by every country. The number of adults with diabetes today is 382 million and is bound to increase to 592 million in 2035. The greatest number of people with diabetes is between 40 and 59 years of age. More than 80% of people with diabetes live in low- and middle-income countries. [1] Community-based randomized, controlled prevention trials, conducted in the past 2 decades have unequivocally shown that primary prevention of diabetes is possible in all ethnic groups by lifestyle modification (LSM) or by a few pharmacological agents. [2] Extended trials such as the Chinese Da Qing study, [3] the Diabetes Prevention Programme Outcomes Study (DPPOS) in USA, [4] and the Finnish Diabetes Prevention Study [5] have indicated that the benefits of LSM can last for periods, varying from 10 to 20 years. Diabetes occurs from genetic and environmental interaction. Genetic factors do not change in a short period, hence the recent epidemic o Continue reading >>
Resource | Beta Cells In Diabetes
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Knowler, William C; Fowler, Sarah E; Hamman, Richard F; Christophi, Costas A; Hoffman, Heather J; Brenneman, Anne T; Brown-Friday, Janet O; Goldberg, Ronald; Venditti, Elizabeth; Nathan, David M Lancet; 2009 Nov 14;374(9702):1677-86. PMID: 19878986 BACKGROUND: In the 2.8 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. METHODS: All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5.7 years (IQR 5.5-5.8). 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. FINDINGS: During the 10.0-year (IQR 9.0-10.5) 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 4.8 cases per Continue reading >>
Implementation Of The Ymca Diabetes Prevention Program Throughout An Integrated Health System: A Translational Study
Implementation of the YMCA Diabetes Prevention Program throughout an Integrated Health System: A Translational Study Perm J 2016 Fall;20(4):15-241 [Full Citation] Context: HealthSpan Physicians (HSP), an integrated medical system in Northeast Ohio, partnered with the Young Mens Christian Association (YMCA) of Greater Cleveland to implement a referral system for the evidence-based Diabetes Prevention Program (DPP) throughout HSP. The YMCA of USA employs a cost-effective, customized version of the original DPP in which coaches take the place of in-house clinical staff. Efficacy of the YMCA DPP was shown earlier in the DEPLOY Study. Objective: To improve outcomes of metrics used in the DEPLOY Study. Design: Observational study focusing on engagement, persistence, recruitment, and adherence to the DPP. In August 2014, HSP mailed an invitation to 2200 patients identified as both Medicare eligible and at risk of prediabetes to attend no-obligation information sessions about the DPP. After these sessions, YMCA staff called interested participants and asked them to enroll in and to commit to the program. Motivation and reinforcement were provided to patients through YMCA-provided signs, brochures, and posters; the HSP Web site; and in-person conversations with primary care physicians. Main Outcome Measures: Average weight loss at the end of 16 weeks in the program and average retention through Session 9. Results: Of the 2200 patients contacted, 351 (16.0%) responded by attending the information session, and 228 enrolled in the YMCA DPP (11.3%) and persisted through at least Week 9. This result is an improvement over the 1.7% of eligible enrollees who responded to the DEPLOY Studys mailing. Conclusions: A marketing approach to implementing the YMCA DPP in an integrated medical Continue reading >>
Diabetes Prevention Initiative | Joslin Diabetes Center
The Diabetes Prevention Initiative at Joslin Diabetes Center Joslin Diabetes Center is excited to launch a new initiative aimed at exploring new ways to implement diabetes prevention on a national scale through education, treatment and affiliation networks. This will be an ongoing effort focused on: engaging academic, patient advocacy, public and private sector resources; and addressing cost-effective efforts to bring diabetes prevention to scale. On July 12, 2011, Joslin convened a group of researchers, clinicians, advocates, and policymakers in Washington, D.C. to discuss how to effectively translate the best and most current evidence on diabetes prevention into practice. The discussioncentered around the landmark Diabetes Prevention Program (DPP) and subsequent studies that tested various translationprojects in the community. The group thendiscussed what would be required tooperationalize the findings. The Diabetes Prevention Summit: Translating Clinical Science into Practice A by-invitation-only consensus summit co-sponsored by JoslinDiabetes Center and Health Affairs. John L. Brooks III, President and CEO, Joslin Diabetes Center Sachin Jain, MD, Physician, Brigham and Women's Hospital and Former Senior Advisor to the Administrator, Center for Medicare and Medicaid Services Susan Dentzer, Editor-in-Chief, Health Affairs The Diabetes PreventionSummit meeting convened by Joslin Diabetes Center and Health Affairs brought together leaders in the diabetes community clinicians, researchers, patient advocates, and payers. The Innovation Center received valuable input regarding potential innovative care delivery and payment models for diabetes patients and providers that can reduce costs while improving quality. Richard Gilfillan, MD. Acting Director, Center for Medicare a Continue reading >>
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 >>
- Crossfit: How This Man Gained 20kg Of Muscle Despite Having Diabetes
- 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
