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- November 20, 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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| Presentation |
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"The Diabetes Prevention Program: A Randomized Clinical Trial to Prevent Type 2 Diabetes in Persons at High Risk"Prof. Elizabeth Barrett-Connor (biography)
English - 2005-04-15 - 38 minutes
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Summary :
The DPP randomized controlled clinical trial included 3234 participants with impaired glucose tolerance (IGT) who were randomized to ILS, MET, or usual advice. Both ILS and MET significantly reduced the risk of diabetes. A further major benefit of these interventions may be reduction of cardiovascular disease (CVD) risk. Because persons with IGT have a high prevalence of CVD risk factors, collectively known as the Metabolic Syndrome (MS), we examined
1) prevalence of MS at baseline;
and 2) effect of DPP interventions on new MS incidence using > 3 of the following U.S. criteria: high fasting plasma glucose (FPG) [>6.1 mmol/L], elevated triglycerides [>1.7 mmol/L], abdominal obesity [waist circumference >102 cm men, >88 cm women], high blood pressure (BP) [³130/85 mmHG], and low HDL cholesterol (HDLc) [<0.9 mmol/L men, <1.0 mmol/L women].
The baseline prevalence of MS was 53% and was comparable among the treatment groups. The prevalence of certain MS components varied by age, e.g., a low HDLc was more frequent in younger (<45 y) compared to the oldest (>60 y) participants (70% vs. 41%), whereas high BP showed the opposite trend (31% vs. 63%) (both p<0.05).
Among the 1523 participants without MS at baseline, the incidence of MS was reduced by 41% (p<0.001) in 3 y of follow-up in the ILS group and by 17% (p<0.04) in the MET group compared to placebo. Both interventions were equally effective in reducing the incidence of high FPG (43%) compared to placebo. The interventions were least effective in reducing the incidence of low HDLc with only 15% for ILS and 13% for MET (both nonsignificant). The MS criterion most affected by DPP interventions was abdominal obesity, the incidence of which was reduced by 78% (ILS) and 50% (MET) compared to placebo (both p<0.001).
Conclusions:
1) 53% of IGT participants in the DPP had MS at baseline.
2) ILS and MET reduced the risk of developing MS; ILS was more than twice as effective as MET.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The objective, design and outcomes of the Diabetes Prevention Program (DPP);
- Adverse events in the DPP;
- Treatment effect of the DPP on hypertension, dyslipidemia, and the metabolic syndrome;
- The effect of age, sex, ethnicity, and body mass index on the incidence of diabetes.
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