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A lifestyle intervention or metformin prevented or delayed the onset of type 2 diabetes in people at risk

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 QUESTION: In overweight people with increased fasting and postload plasma glucose concentrations, does an intensive lifestyle intervention or treatment with metformin plus standard lifestyle recommendations prevent or delay the onset of type 2 diabetes mellitus?


Randomised (allocation concealed*), blinded (clinicians and participants for metformin and placebo),* placebo controlled trial with mean follow up of 2.8 years.


27 centres in the US.


3234 participants (mean age 51 y, 68% women) without diabetes who had a body mass index ≥24 (≥22 for Asians) and a plasma glucose concentration of 5.3 to 6.9 mmol/l in the fasting state and 7.8 to 11.0 mmol/l 2 hours after a 75 g oral glucose load. Exclusion criteria included medications known to alter glucose tolerance and illnesses that could seriously reduce life …

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  • Sources of funding: 8 funding agencies.

  • For correspondence: Diabetes Prevention Program Research Group, George Washington University, Rockville, Maryland, USA. fowler{at}

  • * See glossary.