Christopher Saudek died on 6 October 2010. This paper is dedicated to his memory and his outstanding service to DPPOS.
Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study
Article first published online: 13 DEC 2012
© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK
Volume 30, Issue 1, pages 46–55, January 2013
How to Cite
The Diabetes Prevention Program Outcomes Study Research Group; prepared on behalf of the DPPOS Research Group, Orchard, T. J., Temprosa, M., Barrett-Connor, E., Fowler, S. E., Goldberg, R. B., Mather, K. J., Marcovina, S. M., Montez, M., Ratner, R. E., Saudek, C. D., Sherif, H. and Watson, K. E. (2013), Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study. Diabetic Medicine, 30: 46–55. doi: 10.1111/j.1464-5491.2012.03750.x
(Clinical Trials Registry No; NCT 00038727).
- Issue published online: 13 DEC 2012
- Article first published online: 13 DEC 2012
- Accepted manuscript online: 19 JUL 2012 03:36PM EST
- Accepted 7 June 2012
Diabet. Med. 30, 46–55 (2013)
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.