Long-term weight loss with metformin or lifestyle intervention in the Diabetes prevention Program outcomes study

Diabetes Prevention Program Research Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Identifying reliable predictors of long-term weight loss (LTWL) could lead to improved weight management. Objective: To identify some predictors of LTWL. Design: The DPP (Diabetes Prevention Program) was a randomized controlled trial that compared weight loss with metformin, intensive lifestyle intervention (ILS), or placebo. Its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. (ClinicalTrials.gov: NCT00004992 and NCT00038727) Setting: 27 DPP and DPPOS clinics. Participants: Of the 3234 randomly assigned participants, 1066 lost at least 5% of baseline weight in the first year and were followed for 15 years. Measurements: Treatment assignment, personal characteristics, and weight. Results: After 1 year, 289 (28.5%) participants in the metformin group, 640 (62.6%) in the ILS group, and 137 (13.4%) in the placebo group had lost at least 5% of their weight. After the masked treatment phase ended, the mean weight loss relative to baseline that was maintained between years 6 and 15 was 6.2% (95% CI, 5.2% to 7.2%) in the metformin group, 3.7% (CI, 3.1% to 4.4%) in the ILS group, and 2.8% (CI, 1.3% to 4.4%) in the placebo group. Independent predictors of LTWL included greater weight loss in the first year in all groups, older age and continued metformin use in the metformin group, older age and absence of either diabetes or a family history of diabetes in the ILS group, and higher fasting plasma glucose levels at baseline in the placebo group. Limitation: Post hoc analysis; examination of nonrandomized subsets of randomized groups after year 1. Conclusion: Among persons with weight loss of at least 5% after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15. Older age and the amount of weight initially lost were the most consistent predictors of LTWL maintenance.

Original languageEnglish (US)
Pages (from-to)682-690
Number of pages9
JournalAnnals of internal medicine
Volume170
Issue number10
DOIs
StatePublished - Jan 1 2019

Fingerprint

Metformin
Life Style
Weight Loss
Outcome Assessment (Health Care)
Weights and Measures
Placebos
Age Groups
Fasting
Therapeutics
Randomized Controlled Trials
Maintenance
Glucose

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Long-term weight loss with metformin or lifestyle intervention in the Diabetes prevention Program outcomes study. / Diabetes Prevention Program Research Group.

In: Annals of internal medicine, Vol. 170, No. 10, 01.01.2019, p. 682-690.

Research output: Contribution to journalArticle

@article{685d0f0622394bc18274bbd30a618d58,
title = "Long-term weight loss with metformin or lifestyle intervention in the Diabetes prevention Program outcomes study",
abstract = "Background: Identifying reliable predictors of long-term weight loss (LTWL) could lead to improved weight management. Objective: To identify some predictors of LTWL. Design: The DPP (Diabetes Prevention Program) was a randomized controlled trial that compared weight loss with metformin, intensive lifestyle intervention (ILS), or placebo. Its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. (ClinicalTrials.gov: NCT00004992 and NCT00038727) Setting: 27 DPP and DPPOS clinics. Participants: Of the 3234 randomly assigned participants, 1066 lost at least 5{\%} of baseline weight in the first year and were followed for 15 years. Measurements: Treatment assignment, personal characteristics, and weight. Results: After 1 year, 289 (28.5{\%}) participants in the metformin group, 640 (62.6{\%}) in the ILS group, and 137 (13.4{\%}) in the placebo group had lost at least 5{\%} of their weight. After the masked treatment phase ended, the mean weight loss relative to baseline that was maintained between years 6 and 15 was 6.2{\%} (95{\%} CI, 5.2{\%} to 7.2{\%}) in the metformin group, 3.7{\%} (CI, 3.1{\%} to 4.4{\%}) in the ILS group, and 2.8{\%} (CI, 1.3{\%} to 4.4{\%}) in the placebo group. Independent predictors of LTWL included greater weight loss in the first year in all groups, older age and continued metformin use in the metformin group, older age and absence of either diabetes or a family history of diabetes in the ILS group, and higher fasting plasma glucose levels at baseline in the placebo group. Limitation: Post hoc analysis; examination of nonrandomized subsets of randomized groups after year 1. Conclusion: Among persons with weight loss of at least 5{\%} after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15. Older age and the amount of weight initially lost were the most consistent predictors of LTWL maintenance.",
author = "{Diabetes Prevention Program Research Group} and Apolzan, {John W.} and Venditti, {Elizabeth M.} and Edelstein, {Sharon L.} and Knowler, {William C.} and Dana Dabelea and Boyko, {Edward J.} and Xavier Pi-Sunyer and Kalyani, {Rita R.} and Franks, {Paul W.} and Preethi Srikanthan and Gadde, {Kishore M.} and Bray, {George A.} and Annie Chatellier and Jennifer Arceneaux and Amber Dragg and Crystal Duncan and Greenway, {Frank L.} and Erma Levy and Monica Lockett and Ryan, {Donna H.} and David Ehrmann and Matulik, {Margaret J.} and Kirsten Czech and Catherine DeSandre and Goldstein, {Barry J.} and Kevin Furlong and Smith, {Kellie A.} and Wendi Wildman and Constance Pepe and Goldberg, {Ronald B.} and Jeanette Calles and Juliet Ojito and Sumaya Castillo-Florez and Florez, {Hermes J.} and Anna Giannella and Olga Lara and Beth Veciana and Haffner, {Steven M.} and Hazuda, {Helen P.} and Montez, {Maria G.} and Kathy Hattaway and Carlos Lorenzo and Arlene Martinez and Tatiana Walker and Hamman, {Richard F.} and Lisa Testaverde and Denise Anderson and David Marrero and Kieren Mather and Paris Roach",
year = "2019",
month = "1",
day = "1",
doi = "10.7326/M18-1605",
language = "English (US)",
volume = "170",
pages = "682--690",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "10",

}

TY - JOUR

T1 - Long-term weight loss with metformin or lifestyle intervention in the Diabetes prevention Program outcomes study

AU - Diabetes Prevention Program Research Group

AU - Apolzan, John W.

AU - Venditti, Elizabeth M.

AU - Edelstein, Sharon L.

AU - Knowler, William C.

AU - Dabelea, Dana

AU - Boyko, Edward J.

AU - Pi-Sunyer, Xavier

AU - Kalyani, Rita R.

AU - Franks, Paul W.

AU - Srikanthan, Preethi

AU - Gadde, Kishore M.

AU - Bray, George A.

AU - Chatellier, Annie

AU - Arceneaux, Jennifer

AU - Dragg, Amber

AU - Duncan, Crystal

AU - Greenway, Frank L.

AU - Levy, Erma

AU - Lockett, Monica

AU - Ryan, Donna H.

AU - Ehrmann, David

AU - Matulik, Margaret J.

AU - Czech, Kirsten

AU - DeSandre, Catherine

AU - Goldstein, Barry J.

AU - Furlong, Kevin

AU - Smith, Kellie A.

AU - Wildman, Wendi

AU - Pepe, Constance

AU - Goldberg, Ronald B.

AU - Calles, Jeanette

AU - Ojito, Juliet

AU - Castillo-Florez, Sumaya

AU - Florez, Hermes J.

AU - Giannella, Anna

AU - Lara, Olga

AU - Veciana, Beth

AU - Haffner, Steven M.

AU - Hazuda, Helen P.

AU - Montez, Maria G.

AU - Hattaway, Kathy

AU - Lorenzo, Carlos

AU - Martinez, Arlene

AU - Walker, Tatiana

AU - Hamman, Richard F.

AU - Testaverde, Lisa

AU - Anderson, Denise

AU - Marrero, David

AU - Mather, Kieren

AU - Roach, Paris

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Identifying reliable predictors of long-term weight loss (LTWL) could lead to improved weight management. Objective: To identify some predictors of LTWL. Design: The DPP (Diabetes Prevention Program) was a randomized controlled trial that compared weight loss with metformin, intensive lifestyle intervention (ILS), or placebo. Its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. (ClinicalTrials.gov: NCT00004992 and NCT00038727) Setting: 27 DPP and DPPOS clinics. Participants: Of the 3234 randomly assigned participants, 1066 lost at least 5% of baseline weight in the first year and were followed for 15 years. Measurements: Treatment assignment, personal characteristics, and weight. Results: After 1 year, 289 (28.5%) participants in the metformin group, 640 (62.6%) in the ILS group, and 137 (13.4%) in the placebo group had lost at least 5% of their weight. After the masked treatment phase ended, the mean weight loss relative to baseline that was maintained between years 6 and 15 was 6.2% (95% CI, 5.2% to 7.2%) in the metformin group, 3.7% (CI, 3.1% to 4.4%) in the ILS group, and 2.8% (CI, 1.3% to 4.4%) in the placebo group. Independent predictors of LTWL included greater weight loss in the first year in all groups, older age and continued metformin use in the metformin group, older age and absence of either diabetes or a family history of diabetes in the ILS group, and higher fasting plasma glucose levels at baseline in the placebo group. Limitation: Post hoc analysis; examination of nonrandomized subsets of randomized groups after year 1. Conclusion: Among persons with weight loss of at least 5% after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15. Older age and the amount of weight initially lost were the most consistent predictors of LTWL maintenance.

AB - Background: Identifying reliable predictors of long-term weight loss (LTWL) could lead to improved weight management. Objective: To identify some predictors of LTWL. Design: The DPP (Diabetes Prevention Program) was a randomized controlled trial that compared weight loss with metformin, intensive lifestyle intervention (ILS), or placebo. Its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. (ClinicalTrials.gov: NCT00004992 and NCT00038727) Setting: 27 DPP and DPPOS clinics. Participants: Of the 3234 randomly assigned participants, 1066 lost at least 5% of baseline weight in the first year and were followed for 15 years. Measurements: Treatment assignment, personal characteristics, and weight. Results: After 1 year, 289 (28.5%) participants in the metformin group, 640 (62.6%) in the ILS group, and 137 (13.4%) in the placebo group had lost at least 5% of their weight. After the masked treatment phase ended, the mean weight loss relative to baseline that was maintained between years 6 and 15 was 6.2% (95% CI, 5.2% to 7.2%) in the metformin group, 3.7% (CI, 3.1% to 4.4%) in the ILS group, and 2.8% (CI, 1.3% to 4.4%) in the placebo group. Independent predictors of LTWL included greater weight loss in the first year in all groups, older age and continued metformin use in the metformin group, older age and absence of either diabetes or a family history of diabetes in the ILS group, and higher fasting plasma glucose levels at baseline in the placebo group. Limitation: Post hoc analysis; examination of nonrandomized subsets of randomized groups after year 1. Conclusion: Among persons with weight loss of at least 5% after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15. Older age and the amount of weight initially lost were the most consistent predictors of LTWL maintenance.

UR - http://www.scopus.com/inward/record.url?scp=85066318815&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066318815&partnerID=8YFLogxK

U2 - 10.7326/M18-1605

DO - 10.7326/M18-1605

M3 - Article

VL - 170

SP - 682

EP - 690

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 10

ER -