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J Clin Endocrinol Metab. 2015 Apr;100(4):1646-53. doi: 10.1210/jc.2014-3761. Epub 2015 Feb 23.

The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up.

Collaborators (270)

Chatellier A, Arceneaux J, Dragg A, Duncan C, Greenway FL, Levy E, Ryan DH, Ehrmann D, Matulik MJ, Czech K, DeSandre C, 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, Hattaway K, Lorenzo C, Martinez A, Walker T, Hamman RF, Dabelea D, Testaverde L, Anderson D, Bouffard A, Jenkins T, Lenz D, Perreault L, Price DW, Steinke SC, Horton ES, Poirier CS, Swift K, Caballero E, Fargnoli B, Guidi A, Guido M, Jackson SD, Lambert L, Lawton KE, Ledbury S, Sansoucy J, Spellman J, Kahn SE, Montgomery BK, Fujimoto W, Knopp RH, Lipkin EW, Morgan-Taggart I, Murillo A, Taylor L, Thomas A, Tsai EC, Trence D, Kitabchi AE, Dagogo-Jack S, Murphy ME, Taylor L, Dolgoff J, Clark D, Ibebuogu U, Lambeth H, Ricks H, Rutledge LM, Soberman JE, Molitch ME, Metzger BE, Johnson MK, Giles MM, Larsen D, Pen SC, Nathan DM, Larkin M, McKitrick C, Turgeon H, Anderson E, Bissett L, Bondi K, Cagliero E, D'Anna K, Delahanty L, Florez JC, Goldman V, Lou P, Poulos A, Raymond E, Stevens C, Tseng B, Barrett-Connor E, Carrion-Petersen ML, Claravall LN, Dowden JM, Horne J, Leos D, Mudaliar S, Smith J, Janisch SS, Vejvoda K, Pi-Sunyer F, Lee JE, Foo ST, Hagamen S, Marrero DG, Mather KJ, Kelly SM, Putenney P, Jackson MA, McAtee G, Ackermann RT, Cantrell CM, Fineberg ES, Hadden A, Kirkman MS, Roach PJ, Ratner RE, Aroda V, Shapiro S, Bavido-Arrage C, Leon L, Gibbs P, Uwaifo G, Wells-Thayer D, Wiggins R, Saad MF, Watson K, Botrous M, Jinagouda S, Budget M, Conzues C, Magpuri P, Ngo K, Xapthalamous K, White NH, Brown AL, Das S, Khare-Ranade P, Stich T, Santiago A, Wernimont C, Saudek CD, Golden SH, Whittington T, Brancati FL, Clark JM, Greene A, Jiggetts D, Mosley H, Reusing J, Rubin RR, Stephens S, Utsey E, Schade DS, Adams KS, Hemphill C, Hyde P, Canady JL, Colleran K, Gonzales Y, Hernandez-McGinnis DA, King C, Crandall J, Brown JO, Trandafirescu G, Adorno E, Duffy H, Goldstein A, Lukin J, Martinez H, Pompi D, Shamoon H, Scheindlin J, Walker EA, Wylie-Rosett J, Orchard T, Kriska A, Jeffries S, Kramer M, Smith M, Benchoff C, Guimond S, Pettigrew J, Rubinstein D, Semler L, Venditti E, Weinzierl V, Arakaki RF, Baker-Ladao NK, Isonaga MK, Bermudez NE, Mau MK, Knowler WC, Cooeyate N, Enote A, Hoskin MA, Natewa C, Percy CA, Acton KJ, Andre VL, Barber R, Begay S, Bucca BC, Cook S, Curtis J, Dodge C, Doughty MS, Glass J, Glass M, Hanson RL, Ingraham LE, Kobus KM, Krakoff J, Manus C, McCabe C, Michaels S, Morgan T, Nelson JA, Piromalli C, Roy RJ, Sangster S, Smart M, Tonemah DP, Williams R, Wilson C, Fowler S, Temprosa M, Larsen MD, Brenneman T, Sherif H, Edelstein SL, Abebe S, Bamdad J, Barkalow M, Bethepu J, Bezabeh T, Butler N, Callaghan J, Christophi C, Dwyer G, Foulkes M, Gao Y, Gooding R, Gottlieb A, Grover N, Hoffman H, Jablonski K, Katz R, Kolinjivadi P, Lachin JM, Ma Y, Pan Q, Reamer S, Sapozhnikova A, Venditti EM, Kriska AM, Semler L, Weinzierl V, Marcovina S, Strylewicz G, Albers J.

Author information

1
MedStar Health Research Institute (V.R.A., R.E.R.), Hyattsville, Maryland 20782; George Washington University Biostatistics Center (C.A.C., S.L.E.), Rockville, Maryland 20852; Centers for Disease Control and Prevention (P.Z., X.Z.), Atlanta, Georgia 30333; University of Michigan (W.H.H.), Ann Arbor, Michigan 48109; University of California, San Diego (E.B.-C.), La Jolla, California 92093; Massachusetts General Hospital and Harvard Medical School (L.M.D.), Boston, Massachusetts 02114; University of Texas Health Science Center at San Antonio (M.G.M.), San Antonio, Texas 78229; Northwestern University Feinberg School of Medicine (R.T.A.), Chicago, Illinois 60611; and National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014.

Abstract

CONTEXT:

Gestational diabetes (GDM) confers a high risk of type 2 diabetes. In the Diabetes Prevention Program (DPP), intensive lifestyle (ILS) and metformin prevented or delayed diabetes in women with a history of GDM.

OBJECTIVE:

The objective of the study was to evaluate the impact of ILS and metformin intervention over 10 years in women with and without a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study.

DESIGN:

This was a randomized controlled clinical trial with an observational follow-up.

SETTING:

The study was conducted at 27 clinical centers.

PARTICIPANTS:

Three hundred fifty women with a history of GDM and 1416 women with previous live births but no history of GDM participated in the study. The participants had an elevated body mass index and fasting glucose and impaired glucose tolerance at study entry.

INTERVENTIONS:

Interventions included placebo, ILS, or metformin.

OUTCOMES MEASURE:

Outcomes measure was diabetes mellitus.

RESULTS:

Over 10 years, women with a history of GDM assigned to placebo had a 48% higher risk of developing diabetes compared with women without a history of GDM. In women with a history of GDM, ILS and metformin reduced progression to diabetes compared with placebo by 35% and 40%, respectively. Among women without a history of GDM, ILS reduced the progression to diabetes by 30%, and metformin did not reduce the progression to diabetes.

CONCLUSIONS:

Women with a history of GDM are at an increased risk of developing diabetes. In women with a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study, both lifestyle and metformin were highly effective in reducing progression to diabetes during a 10-year follow-up period. Among women without a history of GDM, lifestyle but not metformin reduced progression to diabetes.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00004992 NCT00038727.

PMID:
25706240
PMCID:
PMC4399293
DOI:
10.1210/jc.2014-3761
[Indexed for MEDLINE]
Free PMC Article

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