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Evid Based Nurs 5:109 doi:10.1136/ebn.5.4.109
  • Treatment

A lifestyle intervention or metformin prevented or delayed the onset of type 2 diabetes in people at risk


 
 QUESTION: In overweight people with elevated fasting and postload plasma glucose concentrations, does a lifestyle intervention or treatment with metformin prevent or delay the onset of type 2 diabetes mellitus?

Design

Randomised (allocation concealed), blinded (clinicians and participants for metformin and placebo), placebo controlled trial with a mean follow up of 2.8 years (range 1.8–4.6 y).

Setting

27 centres in the US.

Participants

3234 participants ≥25 years of age (mean age 51 y, 68% women) without diabetes who had a body mass index ≥24 kg/m2 (≥22 kg/m2 for Asians), plasma glucose concentration of 5.3–6.9 mmol/l in the fasting state and 7.8–11.0 mmol/l 2 hours after a 75 g oral glucose load. Exclusion criteria included taking medicines known to alter glucose tolerance and illnesses that could seriously reduce life expectancy or ability to participate in the trial. Follow up was 93%.

Intervention

Participants were allocated to an intensive programme of lifestyle modification (n=1079) or standard lifestyle …

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