What question did this study set out to answer?

To assess the 15-year effectiveness of metformin in preventing diabetes and identify specific patient subgroups that derived the greatest benefit.

March 11, 2019Diabetes CareOpen Access

Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

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To assess the 15-year effectiveness of metformin in preventing diabetes and identify specific patient subgroups that derived the greatest benefit.
Adults at high risk of diabetes were randomly assigned to masked placebo (n = 1,082) or metformin 850 mg twice daily (n = 1,073) during the DPP (1996–2001) and continued unmasked metformin in the DPPOS follow-up.
Diabetes incidence was monitored over 15 years postrandomization via fasting glucose, 2-h oral glucose tolerance tests, or HbA1c.
Treatment effects were evaluated across subgroups using hazard ratios (HR) and rate differences (RD).
Over 15 years, metformin reduced diabetes incidence compared with placebo by 17% based on glucose criteria and by 36% based on HbA1c criteria.
Metformin efficacy for glucose-defined diabetes was greater in women with prior gestational diabetes mellitus (HR 0.59, RD −4.57 cases/100 person-years) than parous women without it (HR 0.94, RD −0.38 cases/100 person-years; interaction P = 0.03 for HR, P = 0.01 for RD).
Metformin provided greater rate reductions in subjects with higher baseline HbA1c (RD −3.88 cases/100 person-years for HbA1c 6.0–6.4% vs RD −1.03 for HbA1c <6.0%; P = 0.0001) and higher baseline fasting glucose.

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Implication

Randomized trial demonstrates sustained diabetes risk reduction with metformin in high-risk adults, indicating greatest long-term protection for women with prior gestational diabetes.

Cite This Study

Nathan et al. (2019) studied this question.

synapsesocial.com/papers/6aa143a449f7d351e6b56ccd https://doi.org/10.2337/dc18-1970

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Implication

Randomized trial demonstrates sustained diabetes risk reduction with metformin in high-risk adults, indicating greatest long-term protection for women with prior gestational diabetes.

Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Key Points

Discussion

Implication

Cite This Study

Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Key Points

Discussion

Implication

Cite This Study

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