Intensive lifestyle changes in prediabetes reduce type 2 diabetes risk by 24% over 20 years, outperforming metformin treatment. Digest
Roughly one in three adults in the United States has prediabetes, but most don't know it—and without intervention, many will go on to develop type 2 diabetes. However, the condition isn't inevitable: Evidence shows that targeted lifestyle changes or medication can dramatically reduce risk. A recent study found that people with prediabetes who adopted intensive lifestyle changes were 24% less likely to develop diabetes over the next two decades, consistently outperforming the antidiabetes drug metformin.
Researchers tracked the health of nearly 3,200 participants enrolled in the Diabetes Prevention Program trial for up to 21 years. They randomly assigned participants to one of three groups: an intensive lifestyle intervention, metformin treatment, or a placebo. After the first three years, the placebo group stopped taking the placebo, but the other two groups continued with modified versions of their original treatments. All participants attended a group-based lifestyle program several times per year, and researchers tracked new cases of type 2 diabetes using standard diagnostic criteria.
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Over the two-decade follow-up period, both lifestyle changes and metformin treatment continued to lower the risk of diabetes. People in the lifestyle group were about 24% less likely to develop diabetes than those in the placebo group, while those taking metformin were about 17% less likely. On average, people in the lifestyle group remained free of diabetes for 3.5 years longer than those in the placebo group, while those in the metformin group gained an extra 2.5 diabetes-free years. The most substantial benefits of lifestyle changes were observed among people who started with higher blood sugar levels, while metformin worked best for younger adults.
These findings suggest that early intervention—especially lifestyle changes—can provide long-lasting protection against type 2 diabetes. Learn about powerful lifestyle approaches to reduce diabetes risk in this clip featuring Dr. Rhonda Patrick.