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
2
Fiscal Year
2013
Total Cost
$139,139
Indirect Cost
City
State
Country
Zip Code
McCaffery, Jeanne M; Jablonski, Kathleen A; Franks, Paul W et al. (2016) Replication of the Association of BDNF and MC4R Variants With Dietary Intake in the Diabetes Prevention Program. Psychosom Med :
Aroda, Vanita R; Edelstein, Sharon L; Goldberg, Ronald B et al. (2016) Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab 101:1754-61
Hivert, Marie-France; Christophi, Costas A; Franks, Paul W et al. (2016) Lifestyle and Metformin Ameliorate Insulin Sensitivity Independently of the Genetic Burden of Established Insulin Resistance Variants in Diabetes Prevention Program Participants. Diabetes 65:520-6
Pavkov, Meda E; Nelson, Robert G; Knowler, William C et al. (2015) Elevation of circulating TNF receptors 1 and 2 increases the risk of end-stage renal disease in American Indians with type 2 diabetes. Kidney Int 87:812-9
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Mather, K J; Kim, C; Christophi, C A et al. (2015) Steroid Sex Hormones, Sex Hormone-Binding Globulin, and Diabetes Incidence in the Diabetes Prevention Program. J Clin Endocrinol Metab 100:3778-86
Mather, Kieren J; Pan, Qing; Knowler, William C et al. (2015) Treatment-Induced Changes in Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion in the Diabetes Prevention Program Cohort. PLoS One 10:e0136853
Aroda, V R; Christophi, C A; Edelstein, S L et al. (2015) 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. J Clin Endocrinol Metab 100:1646-53
Marrero, David G; Ma, Yong; de Groot, Mary et al. (2015) Depressive symptoms, antidepressant medication use, and new onset of diabetes in participants of the diabetes prevention program and the diabetes prevention program outcomes study. Psychosom Med 77:303-10

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