Trial reportLancet (London, England)2009
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study.
Trial report in Lancet (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It reports registered trial NCT00038727. Cited by 1,342 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diabetes Prevention Program Outcomes Study
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Personalizing Sleep Interventions to Prevent Type 2 Diabetes in Community Dwelling Adults With Pre-Diabetes
WellStart Type 2 Diabetes Study
The Impact of Consumption of Eggs in the Context of Plant-Based Diets on
Metabolic Syndrome and Severe Obesity: Randomized Nutritional Trial to Study Long Term Effect of Very-low-calories Ketogenic Diet (VLCKD) on Weight Control and Cardiovascular Risk Factors
Who cites it
1,342 citing papers in PubMed, 13 syntheses or guidelines pooled it, 2,995 citations in OpenAlex.
- Multi-ancestry polygenic risk scores for the prediction of type 2 diabetes and complications in diverse ancestries.The lancet. Diabetes & endocrinology · 2026Pooled it
- Effectiveness of Smartphone Application-Based Interventions to Prevent Type 2 Diabetes Mellitus in Individuals With Prediabetes: A Systematic Review and Meta-Analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- Effects of continuous glucose monitoring on physical activity and diet in diabetes: a systematic review and meta-analysis.The international journal of behavioral nutrition and physical activity · 2026Pooled it
- Guideline
- Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Guideline
- Comparative effectiveness of different exercise modality on glycaemic control and lipid profile for prediabetes: systematic review and network meta-analysis.Frontiers in endocrinology · 2025Pooled it
- How effective are church-based weight-loss interventions among Black adults? A systematic review.Obesity (Silver Spring, Md.) · 2024Pooled it
- Cultural Tailoring and Implementation Science for Cardiometabolic Interventions in Asian Americans: A Systematic Review.Nursing open · 2024Pooled it
- 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association.Diabetes & metabolism journal · 2024Guideline
- Metformin for preventing the progression of chronic kidney disease.The Cochrane database of systematic reviews · 2024 · on this mapPooled it
- Pooled it
- Early effective intervention can significantly reduce all-cause mortality in prediabetic patients: a systematic review and meta-analysis based on high-quality clinical studies.Frontiers in endocrinology · 2024Pooled it
- Comprehensive management of gestational diabetes mellitus: practical efficacy of exercise therapy and sustained intervention strategies.Frontiers in endocrinology · 2024Pooled it
- Weight Regain Reverses Caloric Restriction-Induced Benefits on the Insulin-IGF-1 Nutrient-Sensing Pathway: Post Hoc Analysis From the CALERIE-2 Randomized Controlled Trial.Diabetes care · 2026Trial
- Trial
- Trial
- Diabetes prevention in the Caribbean using lifestyle intervention and Metformin escalation (LIME): results from a quasi-experimental study.BMC public health · 2025Trial
- Cost-Effectiveness Analysis of an Intensive Lifestyle Intervention Versus Usual Care for Latino Youth With Prediabetes.Pediatric obesity · 2025Trial
- Trial
- Trial
1,282 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
backgroundIn the 2.8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term.
methodsAll active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5.7 years (IQR 5.5-5.8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727.
findingsDuring the 10.0-year (IQR 9.0-10.5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4.8 cases per 100 person-years (95% CI 4.1-5.7) in the intensive lifestyle intervention group, 7.8 (6.8-8.8) in the metformin group, and 11.0 (9.8-12.3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5.9 per 100 person-years (5.1-6.8) for lifestyle, 4.9 (4.2-5.7) for metformin, and 5.6 (4.8-6.5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24-42) in the lifestyle group and 18% (7-28) in the metformin group compared with placebo.
interpretationDuring follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years.
fundingNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.