Update 2020

WHAT’S NEW ABOUT DIABETES PREVENTION IN 2020?

By Dr. Mariana Gerschenson and Dr. Marjorie Mau

on behalf of the Diabetes Research Center at JABSOM

 
Many things have changed in our day-to-day lives since SARS-CoV2 arrived on our shores and since then … it seems that the world stood still … as we were all locked down in quarantine.

One thing that has NOT CHANGED is our focus and commitment to push forward with RESEARCH that will help scientists around the world to unravel the complexities of diabetes mellitus … with the hope that science will provide new discoveries about DM that will improve the lives of people living with DM and more importantly find ways to PREVENT the development of DM — altogether.

In June 2020, the Diabetes Prevention Program Outcome Study (DPPOS) presented new results at the American Diabetes Association 80th Annual Scientific Meeting.[1] As many of you know, the DPPOS is the continuation of the Diabetes Prevention Program (DPP) the landmark study that showed that modest weight loss (7%) through lifestyle modifications in people with “pre-DM” can prevent or postpone the development of Type 2 DM by ~60%. The DPPOS continued to follow the original DPP participants (88%) and the latest results from the entire DPPOS Group are highlighted below:

• Prevention effects in the original lifestyle group and metformin treatment group remain 22 years after the start of the study with a 25% and 18% reduced risk of diabetes development, respectively, compared with the original placebo group.
• Those participants who did not develop diabetes had a significant 57% and 37% lower risk of developing early changes of eye and kidney disease, respectively, and a 39% lower risk of major cardiovascular disease endpoints, such as heart attacks and stroke.
• Despite the benefits seen with diabetes prevention overall, there was no significant benefit seen with the individual interventions—metformin or the lifestyle intervention—with regard to heart disease or the development of kidney disease or diabetic retinopathy.
• However, there were favorable trends with metformin in stroke reduction and for cardiovascular events in the subgroup of people who started the study before age 45.
• Metformin was associated with a non-significant 12% lower risk of cancer compared with the placebo group.
• The most recent results also showed the intensive lifestyle intervention group had a long-term reduction in the development of frailty.
• The only long-term negative effect observed with any of the interventions was a modest increase in kidney disease with metformin, which appeared only in the oldest group of participants.

The “TAKE HOME” Message is … PREVENTION of DIABETES improves quality of life by reducing the risk for eye, kidney and heart disease associated with DM.

HEALTHY LIFESTYLE and METFORMIN WORKS! To prevent diabetes even after 22 years.

A HEALTHY LIFESTYLE reduces the development of frailty … long term!