Differential Effects of Lifestyle Interventions and Metformin for Preventing Type 2 Diabetes

The American Diabetes Association recommends intensive diet intervention and physical activity counseling for people with impaired glucose tolerance or impaired fasting glucose and suggests that metformin can be considered for such patients (Diabetes Care 2015; 38:Suppl:S31). In this post hoc analysis of data from the Diabetes Prevention Program randomized trial (NEJM JW Gen Med Mar 15 2002 and N Engl J Med 2002; 346:393), researchers determined in which patients lifestyle modification or metformin therapy was most likely to prevent onset of frank diabetes.

Participants with impaired fasting glucose (95–125 mg/dL) or abnormal glucose tolerance — but not frank diabetes — were randomized to a lifestyle modification program (with weight-loss an…