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28-10-2009 | Diabetes | Article

Lifestyle changes, metformin use can delay Type 2 diabetes for 10 years

Abstract

Free abstract

MedWire News: Results from the Diabetes Prevention Program Outcomes Study reported in The Lancet show that the beneficial effects of lifestyle intervention or treatment with metformin for preventing or delaying the onset of Type 2 diabetes can persist for at least 10 years.

The initial Diabetes Prevention Program (DPP) study lasted for 2.8 years during which time intensive lifestyle intervention, involving help with weight loss and increasing physical activity, and treatment with metformin reduced the incidence of Type 2 diabetes in high-risk adults by 58% and 31%, respectively, compared with placebo.

In this study, the DPP Research Group based at George Washington University in Rockville, Maryland in the USA investigated how well these effects persisted over the following 7.5-year period between 2001 and 2008.

Of the original 3150 participants, 2766 (88%) participated in the DPP Outcomes Study; 910 from the intensive lifestyle intervention group, 924 from the metformin group, and 932 from the placebo group.

Participants in the metformin group continued to take metformin 850 mg twice daily and those in the lifestyle group were offered continued lifestyle support.

The incidence of Type 2 diabetes in the original study was 4.8, 7.8, and 11 cases per 100 person years in the intensive lifestyle intervention, metformin, and placebo groups, respectively.

In the outcomes study, the respective incidence rates were 5.9, 4.9, and 5.6 per 100 person years.

This translates to a 34% and 18% reduction in the incidence of Type 2 diabetes in the lifestyle intervention and metformin groups, respectively, compared with placebo over the total 10-year follow-up period.

“Prevention of diabetes is a long and winding road. There seems to be no shortcut, and a persistent and prolonged intensive lifestyle intervention seems to be the most effective mode to travel on it,” summarized Anoop Misra (Department of Diabetes and Metabolic Diseases, New Delhi, India) author of an accompanying comment also published The Lancet.

He added: “Because of the high prevalence and rapid increase in the metabolic syndrome and diabetes, there is a need to apply these findings to, and generate data from, other ethnic groups and developing countries.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Helen Albert