News & Research

By: Almas Eftekhari

In 2002, the groundbreaking Diabetes Prevention Program (DPP) clinical trial results showed that in persons with pre-diabetes,after three years of follow-up, intensive lifestyle modification reduced the incidence of type 2 diabetes development by 58%, while metformin treatment reduced diabetes incidence by 31%, compared to control participants receiving standard lifestyle recommendations. The longevity of these positive results was uncertain at that point.

As featured in HealthDay News, Association-funded researcher William C. Knowler, MD, DrPH, of the National Institute of Diabetes and Digestive and Kidney Diseases, who was part of the original DPP trial, recently co-authored an article reporting the results of a 10-year follow-up Diabetes Prevention Program Outcomes Study (DPPOS) in participants from the original trial. At the conclusion of the original DPP study, the intensive lifestyle modification group showed the largest weight loss of 15 pounds, while metformin users experienced a loss of four pounds, compared to control participants. During the 10-year follow-up, the intensive lifestyle group partly regained weight, while the metformin group maintained their weight loss, resulting in similar weights for participants in both groups. While diabetes incidence rates after 10 years were similar for all three groups, the cumulative type 2 diabetes incidence was still reduced in the intensive lifestyle group (34%) and metformin groups (18%) compared to control participants.

Dr. Knowler states, "Interventions that result in weight loss lower the risk of diabetes, and that lower risk appears to persist for a long period of time." The results of the DPPOS, published in  the November 2009 issue of The Lancet, proves that lifestyle changes including healthy diet and exercise, as well as metformin therapy although to a lesser extent, can decrease the risk of type 2 diabetes by more than one third—even several years after the initial intervention. Beginning such a regimen later in life still enables similar health benefits. "Lifestyle intervention, even when   provided later, also seemed to lower diabetes incidence rate," Dr. Knowler confirms. Although the results of the study offer promising health recommendations for pre-diabetic adults, further follow-up of the participants is vital to determine the impact on diabetes progression and its complications.

(Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM.10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet. 2009 Nov 14; 374(9702):1677-86.)