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

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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?


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).


27 centres in the US.


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 …

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  • Sources of funding: National Institutes of Health; Indian Health Service; Centers for Disease Control and Prevention; General Clinical Research Center Program; National Center for Research Resources; American Diabetes Association; Bristol-Myers Squibb; and Parke-Davis.

  • For correspondence: Diabetes Prevention Program Research Group, George Washington University, Rockville, MD, USA.fowler{at}

  • A modified version of this abstract appears in ACP Journal Club.