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- May 12, 2008 |
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Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"The Diabetes Prevention Program"Dr. William C. Knowler (biography)
English - 2005-04-15 - 28 minutes
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Summary :
The DPP was a randomized clinical trial of type 2 diabetes prevention in high-risk persons conducted in 27 clinics in the U.S.A. From 1996-98, participants were randomly assigned to treatment with placebo, metformin, troglitazone, or intensive lifestyle intervention. Due to concern regarding its liver toxicity, use of troglitazone was discontinued in 1998. Randomization to the other three groups continued until 1999, and these treatments were continued until 2001, for an average follow-up of 2.8 years. Diabetes incidence rates were 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo (n=1,082), metformin (n=1,073), and lifestyle (n=1,079) groups (p<0.001 for all three pairwise comparisons). Among the 387 troglitazone participants, diabetes incidence was 3.0 per 100 person-years during a mean of 0.9 years of troglitazone treatment, significantly lower than in the placebo and metformin participants randomized and followed during the same period, but not significantly different from lifestyle. Troglitazone’s preventive action did not persist, because the diabetes incidence rate increased to that of the placebo group once the drug was discontinued. In conclusion, among the larger group of 3,234 participants, lifestyle produced the greatest reduction in diabetes incidence, followed by metformin. In the smaller group of participants assigned to troglitazone for a shorter period of treatment, this drug effectively reduced diabetes incidence, suggesting that troglitazone might have been at least as effective as the lifestyle intervention if it could have been continued. Whether other thiazolidinedione drugs, when used for longer periods, can safely prevent diabetes remains to be determined.
Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The objective of the diabetes prevention program (DPP)
• The medical and lifestyle interventions in subjects enrolled in the DPP
• The DPP study design and changes
• The results of the DPP
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