Diabetes prevention program
National Diabetes Information Clearinghouse
was a major clinical trial, or research study,
received information on diet and exercise,
troglitazone (Rezulin), but this part of the
delay the onset of type 2 diabetes in people
with impaired glucose tolerance (IGT).
The answer is yes. In fact, the DPP found
that over the 3 years of the study, diet and
All 3,234 study participants were overweight
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
DPP Study Design
Diabetes is a disorder that affects the way
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,
of Health and
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.
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
(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.
1 Information WayBethesda, MD 20892–3560Phone: 1–800–860–8747Fax: 703–738–4929Email: [email protected]
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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