Diabetes prevention program

National Diabetes Information Clearinghouse
was a major clinical trial, or research study, received information on diet and exercise, National
troglitazone (Rezulin), but this part of the Institute of
Diabetes and
delay the onset of type 2 diabetes in people Digestive
with impaired glucose tolerance (IGT).
and Kidney
Diseases
The answer is yes. In fact, the DPP found NATIONAL
that over the 3 years of the study, diet and All 3,234 study participants were overweight INSTITUTES
OF HEALTH
exercise sharply reduced the chances that a person with IGT would develop diabetes.
risk factors for the development of type 2 Metformin also reduced risk, although less participants were from minority groups— questions so quickly that, on the advice of an external monitoring board, the program Latino, Asian American or Pacific Islander, or American Indian—that are at increased published their findings in the February 7, 2002, issue of the New England Journal ofMedicine. Type 2 Diabetes and
Pre-diabetes
DPP Study Design
Diabetes is a disorder that affects the way and Goals
In the DPP, participants from 27 clinical and energy. Normally, the food you eat is split into different treatment groups. The then passes into your bloodstream, where it first group, called the lifestyle intervention is used by your cells for growth and energy.
group, received intensive training in diet, For glucose to reach your cells, however, insulin must be present. Insulin is a hor- eating less fat and fewer calories and exer- cising for a total of 150 minutes a week, they aimed to lose 7 percent of their bodyweight and maintain that loss.
Most people with type 2 diabetes have two problems: the pancreas may not pro- duce enough insulin, and fat, muscle, and liver cells cannot use it effectively. This received placebo pills instead of metformin.
means that glucose builds up in the blood, U.S. Department
of Health and
Human Services
overflows into the urine, and passes out of the body—without fulfilling its role as the • you are fairly inactive, or you exercise States have diabetes. Of those, 14.6 million are diagnosed and 6.2 million are undiag-nosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the United States, according to new esti- the main cause of kidney failure, limb ampu- tation, and new-onset blindness in American adults. People with diabetes are also two to percent of U.S. adults ages 40 to 74—or 41 four times more likely than people without million people—had pre-diabetes in 2000.
New data suggest that at least 54 millionU.S. adults had pre-diabetes in 2002.
Pre-diabetes, also called impaired glucose Those with pre-diabetes are likely to devel- tolerance (IGT) or impaired fasting glucose op type 2 diabetes within 10 years, unless (IFG), is a condition in which your blood they take steps to prevent or delay diabetes.
glucose (blood sugar) levels are higher than normal but not high enough for a diagnosis of diabetes. Having pre-diabetes puts you and regular exercise can prevent or delay at higher risk for developing type 2 diabetes.
If you have pre-diabetes, you are also atincreased risk for developing heart disease.
DPP Results
The DPP’s striking results tell us that millions of high-risk people can use diet,exercise, and behavior modification to avoid developing type 2 diabetes. The DPP also suggests that metformin is effective indelaying the onset of diabetes.
• you have a parent, brother, or sister Participants in the lifestyle interventiongroup—those receiving intensive counseling on effective diet, exercise, and behavior modification—reduced their risk of devel- oping diabetes by 58 percent. This finding was true across all participating ethnicgroups and for both men and women.
Lifestyle changes worked particularly well for participants aged 60 and older, reducing their risk by 71 percent. About 5 percent of • your blood pressure is 140/90 or higher, the lifestyle intervention group developed diabetes each year during the study period, compared with 11 percent in those who didnot get the intervention. Researchers think that weight loss—achieved through better eating habits and exercise—reduces the risk of diabetes by improving the ability of the would further reduce the risk of developing body to use insulin and process glucose.
their risk of developing diabetes by 31 per- ing the roles of lifestyle and metformin in preventing type 2 diabetes. They will also men and women, but it was least effective continue to monitor participants to learn more about the study’s long-term effects.
was most effective in people 25 to 44 years old and in those with a body mass index of 35 or higher (at least 60 pounds overweight).
cost-effective methods of delivering life- style modifications in group settings and sustain behavior change and weight loss.
The National Diabetes Education Program Future Research
(NDEP)—a joint project of the NationalInstitutes of Health (NIH), the Centers for Researchers will perform other analyses to try to determine the relative contribution organizations—will disseminate the find- ings and protocols stemming from the DPP.
examine diet versus exercise, however, sothe analyses may not provide a definitiveanswer. Researchers will also analyze The U.S. Government does not endorse or favor any specific commercial product or company.
Trade, proprietary, or company names appearing metformin affect the development of heart in this document are used only because they are and blood vessel diseases, which are more considered necessary in the context of theinformation provided. If a product is not imply that the product is unsatisfactory.
National Diabetes
Information Clearinghouse
1 Information WayBethesda, MD 20892–3560Phone: 1–800–860–8747Fax: 703–738–4929Email: ndic@info.niddk.nih.govInternet: www.diabetes.niddk.nih.gov The National Diabetes InformationClearinghouse (NDIC) is a service of theNational Institute of Diabetes and Digestiveand Kidney Diseases (NIDDK). The NIDDKis part of the National Institutes of Healthunder the U.S. Department of Health andHuman Services. Established in 1978, theClearinghouse provides information aboutdiabetes to people with diabetes and to theirfamilies, health care professionals, and thepublic. The NDIC answers inquiries, developsand distributes publications, and works closelywith professional and patient organizations andGovernment agencies to coordinate resourcesabout diabetes.
Publications produced by the Clearinghouse arecarefully reviewed by both NIDDK scientists andoutside experts. This fact sheet was reviewed byDavid M. Nathan, M.D., Massachusetts GeneralHospital.
This publication is not copyrighted. TheClearinghouse encourages users of this factsheet to duplicate and distribute as manycopies as desired.
This fact sheet is also available at www.diabetes.niddk.nih.gov. U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICESNational Institutes of HealthNIH Publication No. 06–5099August 2006

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