FRIDAY, May 27, 2022 (HealthDay News) — Neither lifestyle intervention nor metformin reduced major cardiovascular events in adults with prediabetes during the 21-year Diabetes Prevention Program Outcomes Study (DPPOS), according to research published online May 23 in Circulation.

Ronald B. Goldberg, M.D., from the University of Miami Miller School of Medicine, and colleagues randomly assigned 3,234 participants with impaired glucose tolerance to metformin twice daily, intensive lifestyle, or placebo and followed them for three years during the Diabetes Prevention Program (DPP) trial. Participants were offered a less intensive lifestyle intervention, and unmasked metformin was continued during the next 18-year average follow-up in DPPOS. The first occurrence of nonfatal myocardial infarction, stroke, or cardiovascular death was examined as the primary outcome.

The researchers found that neither metformin nor lifestyle intervention reduced the primary outcome compared with placebo. The results were not altered with risk factor adjustment. Neither intervention had an effect on the extended cardiovascular outcome, which included the primary outcome or hospitalization for heart failure or unstable angina, coronary or peripheral revascularization, coronary heart disease, or silent myocardial infarction.

“The fact that neither a lifestyle intervention program nor metformin led to a decrease in cardiovascular disease among people with prediabetes may mean that these interventions have limited or no effectiveness in preventing cardiovascular disease, even though they are highly effective in preventing or delaying the development of type 2 diabetes,” Goldberg said in a statement.

Several pharmaceutical and nutrition companies donated materials, equipment, or medicines for DPP/DPPOS; one author disclosed financial ties to the pharmaceutical industry.

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