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August 5, 2022

Lifestyle changes and medication effective in preventing or delaying type 2 diabetes, research finds

New research by the Diabetes Prevention Program Outcomes Study (DPPOS) has found that a long-term lifestyle intervention program involving increased physical activity, healthy eating and aiming for a weight loss of 7% or more is effective in delaying or preventing type 2 diabetes in adults with prediabetes. Similar results were also found in participants using the medication metformin.

This latest study evaluated a 21-year follow-up involving 3,234 adults who had participated in the original 3-year Diabetes Prevention (DPP) trial. The DPPOS analysed whether metformin or lifestyle intervention could reduce the risks of developing cardiovascular disease or having a major cardiac event such as a heart attack, stroke or death.

Ronald B. Goldberg, M.D., chair of the writing group for the DPPOS, said:

“The risk of cardiovascular disease in people with prediabetes is increased, and CVD risk further increases over time after Type 2 diabetes develops and progresses.

“We were focused on assessing the impact of lifestyle or metformin interventions for prevention of Type 2 diabetes in people with prediabetes to reduce cardiovascular disease.”

Of the adults that took part in the original DPP trial, the adults in the lifestyle intervention group reduced the incidence of developing type 2 diabetes by 58%, while those who took a twice-daily dose of metformin reduced the incidence of type 2 diabetes by 31%, in comparison to a placebo group.

Following the DPP trial, the DPPOS started in 2002, with 90% of the original participants enrolling for up to 25years of follow-up to assess the long-term results of the interventions described above.

“From the beginning of the Diabetes Prevention Program, we were primarily interested in whether prevention of diabetes would lead to a reduction in the development of the complications that are caused by Type 2 diabetes — cardiovascular disease, kidney disease, retinopathy and neuropathy,” Goldberg said.

After an average of 21 years of follow-up, there were no notable differences in the incidence of cardiovascular-related events. However, the study did find that there was a continued reduction of an impediment in the development of type 2 diabetes for up to 15 years.

“The fact that neither a lifestyle intervention program nor metformin led to a decrease in cardiovascular disease among people with prediabetes may mean that these interventions have limited or no effectiveness in preventing cardiovascular disease, even though they are highly effective in preventing or delaying the development of Type 2 diabetes,” Goldberg added.

This study was originally published by the American Heart Association.

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