Abstract
Background: Effective prevention is needed to combat the worldwide epidemic of type 2 diabetes. We investigated the long-term extent of beneficial effects of lifestyle intervention and metformin on diabetes prevention, originally shown during the 3-year Diabetes Prevention Program (DPP), and assessed whether these interventions reduced diabetes-associated microvascular complications. Methods: The DPP (1996-2001) was a randomised trial comparing an intensive lifestyle intervention or masked metformin with placebo in a cohort selected to be at very high risk of developing diabetes. All participants were offered lifestyle training at the end of the DPP. 2776 (88%) of the surviving DPP cohort were followed up in the DPP Outcomes Study (DPPOS, Sept 1, 2002, to Jan 2, 2014) and analysed by intention to treat on the basis of their original DPP assignment. During DPPOS, the original lifestyle intervention group was offered lifestyle reinforcement semi-annually and the metformin group received unmasked metformin. The primary outcomes were the development of diabetes and the prevalence of microvascular disease. For the assessment of microvascular disease, we used an aggregate microvascular outcome, composed of nephropathy, retinopathy, and neuropathy. Findings: During a mean follow-up of 15 years, diabetes incidence was reduced by 27% in the lifestyle intervention group (hazard ratio 0·73, 95% CI 0·65-0·83; p
| Original language | English (US) |
|---|---|
| Pages (from-to) | 866-875 |
| Number of pages | 10 |
| Journal | The Lancet Diabetes and Endocrinology |
| Volume | 3 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2015 |
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ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Internal Medicine
- Endocrinology
Cite this
Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up : The Diabetes Prevention Program Outcomes Study. / Diabetes Prevention Program Research Group.
In: The Lancet Diabetes and Endocrinology, Vol. 3, No. 11, 01.11.2015, p. 866-875.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up
T2 - The Diabetes Prevention Program Outcomes Study
AU - Diabetes Prevention Program Research Group
AU - Nathan, David M.
AU - Barrett-Connor, Elizabeth
AU - Crandall, Jill P.
AU - Edelstein, Sharon L.
AU - Goldberg, Ronald B.
AU - Horton, Edward S.
AU - Knowler, William C.
AU - Mather, Kieren J.
AU - Orchard, Trevor J.
AU - Pi-Sunyer, Xavier
AU - Schade, David
AU - Temprosa, Marinella
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background: Effective prevention is needed to combat the worldwide epidemic of type 2 diabetes. We investigated the long-term extent of beneficial effects of lifestyle intervention and metformin on diabetes prevention, originally shown during the 3-year Diabetes Prevention Program (DPP), and assessed whether these interventions reduced diabetes-associated microvascular complications. Methods: The DPP (1996-2001) was a randomised trial comparing an intensive lifestyle intervention or masked metformin with placebo in a cohort selected to be at very high risk of developing diabetes. All participants were offered lifestyle training at the end of the DPP. 2776 (88%) of the surviving DPP cohort were followed up in the DPP Outcomes Study (DPPOS, Sept 1, 2002, to Jan 2, 2014) and analysed by intention to treat on the basis of their original DPP assignment. During DPPOS, the original lifestyle intervention group was offered lifestyle reinforcement semi-annually and the metformin group received unmasked metformin. The primary outcomes were the development of diabetes and the prevalence of microvascular disease. For the assessment of microvascular disease, we used an aggregate microvascular outcome, composed of nephropathy, retinopathy, and neuropathy. Findings: During a mean follow-up of 15 years, diabetes incidence was reduced by 27% in the lifestyle intervention group (hazard ratio 0·73, 95% CI 0·65-0·83; p
AB - Background: Effective prevention is needed to combat the worldwide epidemic of type 2 diabetes. We investigated the long-term extent of beneficial effects of lifestyle intervention and metformin on diabetes prevention, originally shown during the 3-year Diabetes Prevention Program (DPP), and assessed whether these interventions reduced diabetes-associated microvascular complications. Methods: The DPP (1996-2001) was a randomised trial comparing an intensive lifestyle intervention or masked metformin with placebo in a cohort selected to be at very high risk of developing diabetes. All participants were offered lifestyle training at the end of the DPP. 2776 (88%) of the surviving DPP cohort were followed up in the DPP Outcomes Study (DPPOS, Sept 1, 2002, to Jan 2, 2014) and analysed by intention to treat on the basis of their original DPP assignment. During DPPOS, the original lifestyle intervention group was offered lifestyle reinforcement semi-annually and the metformin group received unmasked metformin. The primary outcomes were the development of diabetes and the prevalence of microvascular disease. For the assessment of microvascular disease, we used an aggregate microvascular outcome, composed of nephropathy, retinopathy, and neuropathy. Findings: During a mean follow-up of 15 years, diabetes incidence was reduced by 27% in the lifestyle intervention group (hazard ratio 0·73, 95% CI 0·65-0·83; p
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UR - http://www.scopus.com/inward/citedby.url?scp=84945463952&partnerID=8YFLogxK
U2 - 10.1016/S2213-8587(15)00291-0
DO - 10.1016/S2213-8587(15)00291-0
M3 - Article
C2 - 26377054
AN - SCOPUS:84945463952
VL - 3
SP - 866
EP - 875
JO - The Lancet Diabetes and Endocrinology
JF - The Lancet Diabetes and Endocrinology
SN - 2213-8587
IS - 11
ER -