Diabetes prevention persists over 15 years

Type 2 diabetes

14 Sep 2015

The 15-year results of a diabetes prevention study continue to show that diabetes is best prevented by persistent diet and exercise interventions but more advances are needed, an expert says.

The latest results from the Diabetes Prevention Program Outcomes study (DPPOS) involving 2776 people at high-risk of type 2 diabetes showed that diabetes incidence was reduced by 27% with a lifestyle intervention and by 18% with metformin compared with placebo over 15 years.

This equated to a cumulative diabetes incidence of 55% in the lifestyle group, 56% in the metformin group, and 62% in the placebo group, reported the researchers in the Lancet Diabetes and Endocrinology.

While the prevalence of microvascular disease was also not significantly different between the treatment groups, in women the lifestyle intervention was associated with a 21% reduction in microvascular outcomes compared with placebo.

And participants who did not go on to develop diabetes had a 28% lower prevalence of microvascular complications compared with participants who did, a finding which the authors said supported the importance of diabetes prevention.

“DPPOS has shown the long-term prevention of diabetes and other added benefits of the lifestyle intervention and metformin, such as reduced cardiovascular risk factors, improved quality of life, and even cost savings (with metformin),” the researchers concluded.

Establishing whether long-term microvascular or cardiovascular complications are reduced by the interventions will need further study,” they added.

In an accompanying editorial Anoop Misra from the Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, New Delhi noted that studies of long duration often reveal surprises and disappointments.

For instance the latest data showed that the benefits of lifestyle intervention decreased over time – incidence rates were 34% at 10-year follow-up but were now closer to those seen with the use of metformin.

“Although the Diabetes Prevention Program and its follow-up studies have provided useful information, it is clear that more innovations are needed for more effective and lasting prevention of diabetes. Further dietary manipulations could lead to beneficial results,” she added.


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