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Knowler et al. — Diabetes Prevention Program

One-paragraph summary

The DPP randomised 3,234 high-risk adults to intensive lifestyle, metformin or placebo. Over mean 2.8 years, lifestyle reduced diabetes incidence by 58% and metformin by 31% versus placebo, with lifestyle targeting ≥7% weight loss and ≥150 minutes/week activity (PMID 11832527).

Key findings

  • Intensive lifestyle produced the largest relative incidence reduction.
  • Metformin provided a smaller, scalable pharmacologic effect.
  • Fifteen-year follow-up retained attenuated benefits (PMID 26377054).

Limitations

  • Intervention intensity exceeded routine advice.
  • Crossing a biochemical threshold is not identical to lifelong avoidance.

Why it matters

It made T2D delay/prevention a proven intervention target and set the benchmark for translation programmes.

Cited by wiki pages

  • Biomarkers
  • Overview
  • Pathophysiology and subtypes
  • Patient experience and advocacy
  • Prevention
  • Remission and weight management
  • Youth-onset T2D