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

T. J. Orchard, M. Temprosa, E. Barrett-Connor, S. E. Fowler, R. B. Goldberg, Kieren Mather, S. M. Marcovina, M. Montez, R. E. Ratner, C. D. Saudek, H. Sherif, K. E. Watson

Research output: Contribution to journalArticle

100 Citations (Scopus)

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 10years, 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 3.2years of randomized treatment, approximately 1-year transition (during which all participants were offered intensive lifestyle intervention) and 5years 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 10years' follow-up from Diabetes Prevention Program baseline, major reductions were seen for systolic (-2 to -3) and diastolic (-6 to -6.5mmHg) blood pressure, and for LDL cholesterol (-0.51 to -0.6mmol/l) and triglycerides (-0.23 to -0.25mmol/l) in all groups, with no between-group differences. HDL cholesterol also rose significantly (0.14 to 0.15mmol/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.

Original languageEnglish
Pages (from-to)46-55
Number of pages10
JournalDiabetic Medicine
Volume30
Issue number1
DOIs
StatePublished - Jan 2013

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Life Style
Outcome Assessment (Health Care)
Blood Pressure
Metformin
Cardiovascular Diseases
Placebos
Lipids
Glucose Intolerance
LDL Cholesterol
HDL Cholesterol
Lipoproteins
Triglycerides
Randomized Controlled Trials
Research
Therapeutics

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors : A report from the DPP Outcomes Study. / Orchard, T. J.; Temprosa, M.; Barrett-Connor, E.; Fowler, S. E.; Goldberg, R. B.; Mather, Kieren; Marcovina, S. M.; Montez, M.; Ratner, R. E.; Saudek, C. D.; Sherif, H.; Watson, K. E.

In: Diabetic Medicine, Vol. 30, No. 1, 01.2013, p. 46-55.

Research output: Contribution to journalArticle

Orchard, TJ, Temprosa, M, Barrett-Connor, E, Fowler, SE, Goldberg, RB, Mather, K, Marcovina, SM, Montez, M, Ratner, RE, Saudek, CD, Sherif, H & Watson, KE 2013, 'Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: A report from the DPP Outcomes Study', Diabetic Medicine, vol. 30, no. 1, pp. 46-55. https://doi.org/10.1111/j.1464-5491.2012.03750.x
Orchard, T. J. ; Temprosa, M. ; Barrett-Connor, E. ; Fowler, S. E. ; Goldberg, R. B. ; Mather, Kieren ; Marcovina, S. M. ; Montez, M. ; Ratner, R. E. ; Saudek, C. D. ; Sherif, H. ; Watson, K. E. / Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors : A report from the DPP Outcomes Study. In: Diabetic Medicine. 2013 ; Vol. 30, No. 1. pp. 46-55.
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T2 - A report from the DPP Outcomes Study

AU - Orchard, T. J.

AU - Temprosa, M.

AU - Barrett-Connor, E.

AU - Fowler, S. E.

AU - Goldberg, R. B.

AU - Mather, Kieren

AU - Marcovina, S. M.

AU - Montez, M.

AU - Ratner, R. E.

AU - Saudek, C. D.

AU - Sherif, H.

AU - Watson, K. E.

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N2 - 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 10years, 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 3.2years of randomized treatment, approximately 1-year transition (during which all participants were offered intensive lifestyle intervention) and 5years 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 10years' follow-up from Diabetes Prevention Program baseline, major reductions were seen for systolic (-2 to -3) and diastolic (-6 to -6.5mmHg) blood pressure, and for LDL cholesterol (-0.51 to -0.6mmol/l) and triglycerides (-0.23 to -0.25mmol/l) in all groups, with no between-group differences. HDL cholesterol also rose significantly (0.14 to 0.15mmol/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.

AB - 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 10years, 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 3.2years of randomized treatment, approximately 1-year transition (during which all participants were offered intensive lifestyle intervention) and 5years 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 10years' follow-up from Diabetes Prevention Program baseline, major reductions were seen for systolic (-2 to -3) and diastolic (-6 to -6.5mmHg) blood pressure, and for LDL cholesterol (-0.51 to -0.6mmol/l) and triglycerides (-0.23 to -0.25mmol/l) in all groups, with no between-group differences. HDL cholesterol also rose significantly (0.14 to 0.15mmol/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.

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