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Diabet Med. 2013 Jan;30(1):46-55. doi: 10.1111/j.1464-5491.2012.03750.x.

Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study.

Collaborators (287)

Bray GA, Chatellier A, Duncan C, Greenway FL, Levy E, Ryan DH, Polonsky KS, Tobian J, Ehrmann D, Matulik MJ, Clark B, Czech K, DeSandre C, Hilbrich R, McNabb W, Semenske AR, Goldstein BJ, Furlong K, Smith KA, Wildman W, Pepe C, Goldberg RB, Calles J, Ojito J, Castillo-Florez S, Florez HJ, Giannella A, Lara O, Veciana B, Haffner SM, Hazuda HP, Montez MG, Lorenzo C, Martinez A, Hamman RF, Testaverde L, Bouffard A, Dabelea D, Jenkins T, Lenz D, Perreault L, Price DW, Steinke SC, Horton ES, Poirier CS, Swift K, Caballero E, Jackson SD, Lambert L, Lawton KE, Ledbury S, Kahn SE, Montgomery BK, Fujimoto W, Knopp RH, Lipkin EW, Marr M, Murillo A, Trence D, Kitabchi AE, Murphy ME, Applegate WB, Bryer-Ash M, Dagogo-Jack S, Frieson SL, Lambeth H, Lichtermann LC, Otkaei H, Rutledge LM, Sherman AR, Smith CM, Soberman JE, Williams-Cleaves B, Metzger BE, Molitch ME, Johnson MK, Giles MM, Larsen D, Niznik C, Pen SC, Schinleber PA, Nathan DM, McKitrick C, Turgeon H, Abbott K, Anderson E, Bissett L, Cagliero E, D'Anna K, Delahanty L, Florez JC, Goldman V, Poulos A, Tseng B, Barrett-Connor E, Carrion-Petersen ML, Horne J, Leos D, Mudaliar S, Smith J, Vejvoda K, Pi-Sunyer F, Lee JE, Foo ST, Hagamen S, Marrero DG, Kelly SM, Ackermann RT, Fineberg ES, Hadden A, Jackson MA, Kirkman MS, Mather KJ, Paris, Roach J, Wheeler ML, Ratner RE, Aroda V, Shapiro S, Bavido-Arrage C, Gibbs P, Uwaifo G, Wiggins R, Saad MF, Watson K, Botrous M, Jinagouda S, Budget M, Conzues C, Magpuri P, Ngo K, Xapthalamous K, White NH, Das S, Santiago A, Brown AL, Wernimont C, Saudek CD, Golden SH, Whittington T, Clark JM, Greene A, Jiggetts D, Mosley H, Reusing J, Rubin RR, Stephens S, Utsey E, Schade DS, Adams KS, Hemphill C, Hyde P, Butler L, Canady JL, Colleran K, Gonzales Y, Hernandez-McGinnis DA, Katz P, King C, Crandall J, Brown JO, Adorno E, Duffy H, Martinez H, Pompi D, Shamoon H, Walker EA, Wylie-Rosett J, Orchard T, Jeffries S, Kramer M, Smith M, Wing RR, Kriska A, Pettigrew J, Semler L, Venditti E, Weinzierl V, Arakaki RF, Baker-Ladao NK, Isonaga MK, Bermudez NE, Mau MK, Knowler WC, Cooeyate N, Hoskin MA, Natewa C, Percy CA, Acton KJ, Andre VL, Begay S, Bucca BC, Cook S, Doughty MS, Glass J, Glass M, Hanson RL, Hassenpflug D, Ingraham LE, Kobus KM, Krakoff J, Manus C, McCabe C, Michaels S, Morgan T, Nelson JA, Roy RJ, Smart M, Tonemah DP, Wilson C, Fowler S, Brenneman T, Abebe S, Bamdad J, Barkalow M, Bethepu J, Bezabeh T, Callaghan J, Christophi C, Edelstein SL, Gao Y, Gooding R, Gottlieb A, Grover N, Hoffman H, Jablonski K, Katz R, Kolinjivadi P, Lachin JM, Ma Y, Reamer S, Sapozhnikova A, Sherif H, Temprosa M, Pan Q, Foulkes M, Butler N, Venditti EM, Kriska AM, Semler L, Weinzierl V, Marcovina S, Strylewicz G, Albers J, Prineas RJ, Alexander T, Campbell C, Hall S, Hensley S, Li Y, Mills M, Soliman E, Zhang Z, Danis R, Davis M, Hubbard L, Endres R, Elsas D, Johnson S, Gama V, Goulding A, Evans G, Stamm E, Luchsinger JA, Fradkin J, Garfield S, Gregg E, Zhang P, Herman WH, Brown MB, Mayer-Davis E, Moran RR, Ganiats T, Sarkin AJ, Katzir N, Groessl E, Budoff M, Dailing C, Florez JC, Altshuler D, de Bakker PI, Franks PW, Hanson RL, Jablonski K, Knowler WC, Pollin TI, Shuldiner AR.

Author information

  • 1Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA The Biostatistics Center, George Washington University, Rockville, MD, USA.

Abstract

AIMS:

Whether long-term cardiovascular risk is reduced by the Diabetes Prevention Program interventions is unknown. The aim of this study was to determine the long-term differences in cardiovascular disease risk factors and the use of lipid and blood pressure medications by the original Diabetes Prevention Program intervention group.

METHODS:

This long-term follow-up (median 10 years, interquartile range 9.0-10.5) of the three-arm Diabetes Prevention Program randomized controlled clinical trial (metformin, intensive lifestyle and placebo), performed on 2766 (88%) of the Diabetes Prevention Program participants (who originally had impaired glucose tolerance), comprised a mean of 3.2 years of randomized treatment, approximately 1-year transition (during which all participants were offered intensive lifestyle intervention) and 5 years follow-up (Diabetes Prevention Program Outcomes Study). During the study, participants were followed in their original groups with their clinical care being provided by practitioners outside the research setting. The study determined lipoprotein profiles and blood pressure and medication use annually.

RESULTS:

After 10 years' follow-up from Diabetes Prevention Program baseline, major reductions were seen for systolic (-2 to -3) and diastolic (-6 to -6.5 mmHg) blood pressure, and for LDL cholesterol (-0.51 to -0.6 mmol/l) and triglycerides (-0.23 to -0.25 mmol/l) in all groups, with no between-group differences. HDL cholesterol also rose significantly (0.14 to 0.15 mmol/l) in all groups. Lipid (P = 0.01) and blood pressure (P = 0.09) medication use, however, were lower for the lifestyle group during the Diabetes Prevention Program Outcomes Study.

CONCLUSION:

Overall, intensive lifestyle intervention achieved, with less medication, a comparable long-term effect on cardiovascular disease risk factors, to that seen in the metformin and placebo groups.

© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

PMID:
22812594
[PubMed - indexed for MEDLINE]
PMCID:
PMC3524372
Free PMC Article

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