The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up.

MedStar author(s):
Citation: Journal of Clinical Endocrinology & Metabolism. 100(4):1646-53, 2015 Apr.PMID: 25706240Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Observational Study | Randomized Controlled Trial | Research Support, N.I.H., ExtramuralSubject headings: *Diabetes Mellitus, Type 2/pc [Prevention & Control] | *Diabetes, Gestational/th [Therapy] | *Hypoglycemic Agents/ad [Administration & Dosage] | *Life Style | *Metformin/ad [Administration & Dosage] | *Risk Reduction Behavior | Adult | Diabetes Mellitus, Type 2/ep [Epidemiology] | Diabetes, Gestational/ep [Epidemiology] | Female | Follow-Up Studies | Humans | Incidence | Middle Aged | Pregnancy | Time Factors | Treatment OutcomeYear: 2015Local holdings: Available online through MWHC library: 1999- June 2013, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0021-972X
Name of journal: The Journal of clinical endocrinology and metabolismAbstract: CONCLUSIONS: Women with a history of GDM are at an increased risk of developing diabetes. In women with a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study, both lifestyle and metformin were highly effective in reducing progression to diabetes during a 10-year follow-up period. Among women without a history of GDM, lifestyle but not metformin reduced progression to diabetes.CONTEXT: Gestational diabetes (GDM) confers a high risk of type 2 diabetes. In the Diabetes Prevention Program (DPP), intensive lifestyle (ILS) and metformin prevented or delayed diabetes in women with a history of GDM.DESIGN: This was a randomized controlled clinical trial with an observational follow-up.INTERVENTIONS: Interventions included placebo, ILS, or metformin.OBJECTIVE: The objective of the study was to evaluate the impact of ILS and metformin intervention over 10 years in women with and without a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study.OUTCOMES MEASURE: Outcomes measure was diabetes mellitus.PARTICIPANTS: Three hundred fifty women with a history of GDM and 1416 women with previous live births but no history of GDM participated in the study. The participants had an elevated body mass index and fasting glucose and impaired glucose tolerance at study entry.RESULTS: Over 10 years, women with a history of GDM assigned to placebo had a 48% higher risk of developing diabetes compared with women without a history of GDM. In women with a history of GDM, ILS and metformin reduced progression to diabetes compared with placebo by 35% and 40%, respectively. Among women without a history of GDM, ILS reduced the progression to diabetes by 30%, and metformin did not reduce the progression to diabetes.SETTING: The study was conducted at 27 clinical centers.All authors: Ackermann RT, Aroda VR, Barrett-Connor E, Christophi CA, Delahanty LM, Diabetes Prevention Program Research Group, Edelstein SL, Herman WH, Knowler WC, Montez MG, Ratner RE, Zhang P, Zhuo XFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-01-13
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25706240 Available 25706240

Available online through MWHC library: 1999- June 2013, Available in print through MWHC library: 1999 - 2006

CONCLUSIONS: Women with a history of GDM are at an increased risk of developing diabetes. In women with a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study, both lifestyle and metformin were highly effective in reducing progression to diabetes during a 10-year follow-up period. Among women without a history of GDM, lifestyle but not metformin reduced progression to diabetes.

CONTEXT: Gestational diabetes (GDM) confers a high risk of type 2 diabetes. In the Diabetes Prevention Program (DPP), intensive lifestyle (ILS) and metformin prevented or delayed diabetes in women with a history of GDM.

DESIGN: This was a randomized controlled clinical trial with an observational follow-up.

INTERVENTIONS: Interventions included placebo, ILS, or metformin.

OBJECTIVE: The objective of the study was to evaluate the impact of ILS and metformin intervention over 10 years in women with and without a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study.

OUTCOMES MEASURE: Outcomes measure was diabetes mellitus.

PARTICIPANTS: Three hundred fifty women with a history of GDM and 1416 women with previous live births but no history of GDM participated in the study. The participants had an elevated body mass index and fasting glucose and impaired glucose tolerance at study entry.

RESULTS: Over 10 years, women with a history of GDM assigned to placebo had a 48% higher risk of developing diabetes compared with women without a history of GDM. In women with a history of GDM, ILS and metformin reduced progression to diabetes compared with placebo by 35% and 40%, respectively. Among women without a history of GDM, ILS reduced the progression to diabetes by 30%, and metformin did not reduce the progression to diabetes.

SETTING: The study was conducted at 27 clinical centers.

English

Powered by Koha