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Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Lee, Christine G ; Heckman-Stoddard, Brandy ; Dabelea, Dana ; Gadde, Kishore M ; Ehrmann, David ; Ford, Leslie ; Prorok, Philip ; Boyko, Edward J ; Pi-Sunyer, Xavier ; Wallia, Amisha ; Knowler, William C ; Crandall, Jill P ; Temprosa, Marinella

Diabetes care, 2021-12, Vol.44 (12), p.2775-2782 [Periódico revisado por pares]

United States: American Diabetes Association

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Título:
Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study
Autor: Lee, Christine G ; Heckman-Stoddard, Brandy ; Dabelea, Dana ; Gadde, Kishore M ; Ehrmann, David ; Ford, Leslie ; Prorok, Philip ; Boyko, Edward J ; Pi-Sunyer, Xavier ; Wallia, Amisha ; Knowler, William C ; Crandall, Jill P ; Temprosa, Marinella
Assuntos: Adult ; Adults ; Antidiabetics ; Cancer ; Cardiovascular and Metabolic Risk ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - drug therapy ; Cardiovascular Diseases - prevention & control ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - prevention & control ; Disease prevention ; Health hazards ; Health risks ; Humans ; Hypoglycemic Agents - therapeutic use ; Life Style ; Lifestyles ; Metformin ; Metformin - therapeutic use ; Mortality ; Placebos ; Prevention ; Prevention programs ; Regression analysis ; Regression models ; Research design
É parte de: Diabetes care, 2021-12, Vol.44 (12), p.2775-2782
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SourceType-Scholarly Journals-1
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Descrição: To determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. From 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively. Over a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death ( = 170), followed by cardiovascular disease ( = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality. Cancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.
Editor: United States: American Diabetes Association
Idioma: Inglês

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Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Lee, Christine G ; Heckman-Stoddard, Brandy ; Dabelea, Dana ; Gadde, Kishore M ; Ehrmann, David ; Ford, Leslie ; Prorok, Philip ; Boyko, Edward J ; Pi-Sunyer, Xavier ; Wallia, Amisha ; Knowler, William C ; Crandall, Jill P ; Temprosa, Marinella

United States: American Diabetes Association

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