Reviewing the Results of Interventions in the Longest Running Diabetes Prevention Study

Doctor treating patient with glucose monitor

To mark the sixtieth anniversary of the first clinical use of metformin for diabetes treatment, Diabetologia, the journal of the European Association for the Study of Diabetes, produced a special edition dedicated to the many evolving aspects of metformin use.

Vanita Aroda, MD, was the lead author for “Metformin for Diabetes Prevention: Insights Gained From the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study,” which focused on the long-term effects of metformin in the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). Susana Shapiro, RN, serves as the program manager for DPP/DPPOS at MedStar.

The DPP/DPPOS is the largest and longest clinical trial of metformin for the prevention of diabetes. At MedStar Health, the DPP/DPPOS has been conducted at the MedStar Health Research Institute research location on Capitol Hill. The DPP was designed and initiated in the early 1990s to identify the possibility of delaying or preventing diabetes. Two interventions were identified: treatment with metformin and intensive lifestyle changes.

The DPP enrolled more than 3,200 patients at multiple sites throughout the nation. The study ran until 2001, one year ahead of schedule, “owing to demonstrated efficacy of both metformin and the lifestyle intervention” in preventing or delaying diabetes in participants. Preliminary findings from the study were released in 2002, “showing that the intensive lifestyle intervention and metformin groups had a respective 58% and 31% lower incidence of diabetes than the placebo group.”

Following the DPP, 88% of participants continued into the DPPOS study for an investigation into the long-term effects of the interventions on diabetes prevention, diabetes-associated microvascular complications and cardiovascular disease risk factors.

The impact of prediabetes and diabetes worldwide is enormous, with 415 million adults currently living with diabetes, with a projected increase to 642 million adults by 2040.

Diabetologia, 2017. DOI: 10.1007/s00125-017-4361-9