The DPP, nationally, recruited 3,234 volunteers who received standard lifestyle recommendations and were randomly assigned to one of three interventions: intensive lifestyle with the aim of losing and maintaining 7% weight loss and achieving >150 minutes per week of moderate intensity physical activity, metformin therapy with 850 mg twice per day, or placebo. The development of diabetes in the lifestyle intervention and metformin-treated groups were reduced by 58% and 31%, respectively, compared with the placebo group Many important issues remained unanswered, however. Specifically, whether the decrease in the development of diabetes can be sustained is unknown. Moreover, determining whether the delay or prevention of diabetes will translate into a decrease in retinopathy, nephropathy, neuropathy, and cardiovascular disease, all of which require more years to develop than the DPP period of study, is critical to establish the true impact of the DPP on public health. This long-term follow-up study of the DPP the DPPOS will address these issues. All DPP participants, whether or not they developed diabetes during the DPP, were invited to join DPPOS. 91% of the participants in the American Indian centers chose to continue in DPPOS. This was the highest percentage of any racial/ethnic group in the DPPOS. The DPPOS has continued to progress very smoothly at the American Indian sites operated by the Diabetes Epidemiology and Clinical Research Section. Retention of American Indian participants is excellent. 94% of our participants are still actively followed (defined as not having missed the last two visits), compared with 91% in the study nationally. This allows Southwestern American Indians, a population highly affected by diabetes, to participant in this major clinical trial determining long-term health benefits of diabetes prevention interventions. During the last year, the DPPOS clinical centers obtained retinal photographs of nearly all participants. This will provide an objective assessment of an important complication of diabetes diabetic retinopathy. The photographs were graded at a central reading facility and the results are currently being analyzed. We participated in the development of a multicenter clinical trial evaluating whether vitamin D supplementation can prevent or delay onset of type 2 diabetes (D2d). We plan to participate as one of the contributing sites. We have submitted the protocol and consent forms to the NIDDK IRB and expect to begin data collection in FY 2014.

Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Zip Code
Billings, Liana K; Jablonski, Kathleen A; Ackerman, Rachel J et al. (2014) The influence of rare genetic variation in SLC30A8 on diabetes incidence and ?-cell function. J Clin Endocrinol Metab 99:E926-30
Dabelea, D; Ma, Y; Knowler, W C et al. (2014) Diabetes autoantibodies do not predict progression to diabetes in adults: the Diabetes Prevention Program. Diabet Med 31:1064-8
Franks, Paul W; Christophi, Costas A; Jablonski, Kathleen A et al. (2014) Common variation at PPARGC1A/B and change in body composition and metabolic traits following preventive interventions: the Diabetes Prevention Program. Diabetologia 57:485-90
Sullivan, Shannon D; Jablonski, Kathleen A; Florez, Jose C et al. (2014) Genetic risk of progression to type 2 diabetes and response to intensive lifestyle or metformin in prediabetic women with and without a history of gestational diabetes mellitus. Diabetes Care 37:909-11
Knowler, William C; Ackermann, Ronald T (2014) Response to comment on knowler et Al. Preventing diabetes in american Indian communities. Diabetes care 2013;36:1820-1822. Diabetes Care 37:e37
Chakkera, Harini A; Weil, E Jennifer; Pham, Phuong-Thu et al. (2013) Can new-onset diabetes after kidney transplant be prevented? Diabetes Care 36:1406-12
Knowler, William C; Ackermann, Ronald T (2013) Preventing diabetes in American Indian communities. Diabetes Care 36:1820-2
Price, David W; Ma, Yong; Rubin, Richard R et al. (2013) Depression as a predictor of weight regain among successful weight losers in the diabetes prevention program. Diabetes Care 36:216-21
Diabetes Prevention Program Outcomes Study Research Group; Orchard, T J; Temprosa, M et al. (2013) Long-term effects of the Diabetes Prevention Program interventions on cardiovascular risk factors: a report from the DPP Outcomes Study. Diabet Med 30:46-55