Final
Results of Diabetes Prevention Program Published
Both
lifestyle changes and treatment with metformin can significantly
reduce the risk of diabetes in high-risk individuals, but
lifestyle intervention is more efficacious
That,
according to final findings from the Diabetes Prevention Program
(DPP).
Results from the DPP
were initially reported last August by Department of Health and
Human Services Secretary Tommy G. Thompson. Now the main results
have been published in the New
England Journal of Medicine.
The DPP enrolled
3,234 nondiabetic patients (mean age, 51 years; mean BMI, 34.0)
with elevated fasting and post-load plasma glucose concentrations.
Women and members of minority groups comprised 68% and 45% of the
study group, respectively. Participants were randomized to receive
placebo, metformin (850 mg twice daily), or a
lifestyle-modification program (goals, >/=7% weight loss and
>/0 minutes of physical activity per week).
During an average
follow-up of 2.8 years, diabetes incidence in the placebo,
metformin, and lifestyle-modification groups was 11.0, 7.8, and
4.8 cases per 100 person-years, respectively.
Incidence of
diabetes was reduced by 58% with the lifestyle intervention (95%
CI, 48%-66%) and by 31% with metformin (CI, 17%-43%) compared with
placebo. The reduction in diabetes incidence achieved with
lifestyle intervention was significantly greater than that
achieved with metformin.
During a 3-year
period, the estimated number of patients needed to treat was 6.9
with the lifestyle-intervention program and 13.9 with metformin.
"Our results
support the hypothesis that type 2 diabetes can be prevented or
delayed in persons at high risk for the disease," the authors
wrote. "These effects were similar in men and women and in
all racial and ethnic groups." (Diabetes Prevention Program
Research Group. N
Engl J Med 2002;346:393-403.)
Did
you know?
How
you can explain in plain English the importance of the A1c test
and what it means?
Click
on the link below to print out a feature that explains it to the
patient. (Requires Acrobat Reader)
Patients
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