CDC Statements on Diabetes Issues
 

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CDC Statement on Results of Diabetes Prevention Program

The following is a Centers for Disease Control and Prevention (CDC) statement on the recently announced results of the Diabetes Prevention Program. The study concluded that it is possible to prevent or delay type 2 diabetes.

1. What is the Diabetes Prevention Program?

The Diabetes Prevention Program (DPP) is a 27-center randomized clinical trial that studied more than 3,200 adults who were 25 years or older and who were at increased risk of developing type 2 diabetes. Participants in the DPP included 55 percent who were Caucasian and 45 percent who were minorities -- 20 percent African American, 16 percent Hispanic, 5 percent American Indian, 4 percent Asian American. The DPP evaluated the effectiveness of the following ways to prevent or delay type 2 diabetes:

• intensive lifestyle modification (healthy diet, moderate physical activity of 30 minutes a day 5 days a week)
• standard care plus the drug metformin
• standard care plus placebo (a pill that has no effect).

2. How was increased risk for getting diabetes determined in the study participants?

Their blood glucose or sugar was higher than normal, but not yet high enough to be diabetes. All were overweight, most were obese, and most had a family history of type 2 diabetes.

3. What were the major findings of the DPP?

• This is the first major clinical trial of Americans at high risk for type 2 diabetes to show that lifestyle changes in diet and exercise and losing a little weight can prevent or delay the disease.
• Participants who made lifestyle changes reduced their risk of getting type 2 diabetes by 58 percent.
• The lifestyle intervention was effective for participants of all ages and all ethnic groups.
• Participants with standard care plus metformin reduced their risk for getting type 2 diabetes by 31 percent.

4. What do these results mean to American adults at high risk of getting type 2 diabetes?

• Lifestyle changes can prevent or delay type 2 diabetes in those at high risk.
• At least 10 million Americans have similar characteristics to those in the DPP study.
• About 18.2 million Americans are estimated to have diabetes and the prevalence of diabetes increased dramatically during the 1990s.

5. Should all adults be tested for type 2 diabetes?

• If you weigh more than your ideal weight and have a family history of diabetes, you should discuss testing with your health care provider during a regular check-up.

6. Do the DPP results also apply to children?

• The DPP included only adults aged 25 years or older; however, the pronounced effect of the lifestyle intervention suggests that lifestyle changes will benefit people of any age who are at high risk for developing type 2 diabetes.
• For more information on children and type 2 diabetes, see
  • Children and diabetes
  • CDC School Health Index for Physical Activity and Healthy Eating
  • Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People.

7. What was CDC's role in the DPP?

CDC scientists collaborated with the study team and colleagues at the National Institutes of Health to develop the lifestyle intervention; to design the ongoing economic evaluation; and to design the screening and eligibility requirements of study participants. CDC also provided technical assistance as well as about $2 million for the study.

8. Now that the results of the DPP are in, what are CDC's next steps?

• Translate and share the DPP results with health care professionals, health care policy makers, and people who are at a high risk of developing diabetes.
• Determine how to identify people at high risk and deliver lifestyle interventions in the most efficient and cost effective way.
• Develop ways to improve the health care system to effectively promote positive lifestyles throughout the life cycle.
• Identify community programs that have culturally relevant ways to reach people with messages of hope and support for lifestyle modifications that are consistent with community strengths and values.
• Study how DPP results can be applied at a reasonable cost given the competing needs in the United States.

9. What are the implications of the DPP results for CDC's 59 state and territorial diabetes prevention and control programs (DPCPs) and other local programs?

CDC supports 59 state and territorial DPCPs. These programs focus on community interventions, health communications, and health systems changes to prevent diabetes complications and to improve the health and quality of life for all people with diabetes. DPCPs and their partners help translate promising science into practice to prevent the devastating complications of diabetes, including blindness, amputations, kidney disease, and heart disease.

Diabetes is the sixth leading cause of death ( NVSR 2000;vol. 49, #12 [PDF–2.32 MB] ). With the recent epidemic increases in obesity and diabetes, ensuring that all people with diabetes benefit from what we already know is an enormous challenge.

Based on the findings of the DPP, the following are immediate implications for DPCPs:

1. DPCPs will help assure that DPP study findings are accurately reflected in their program materials, press releases, printed documents, and public comments. DPCPs will also play a critical role in raising awareness of the importance of the DPP study findings among state constituents.
2. DPCPs should aggressively educate state and local policymakers and decision makers on the prevention opportunity derived from this study and the need for additional resources to add primary prevention activities to programs that currently serve people with diabetes.
3. Based on the DPP study findings, DPCPs should encourage and promote in-depth conversations and collaborations with their partners on future program directions.

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Related Links

February 19, 2002
HHS, American Diabetes Association Renew Campaign
to Help People with Diabetes Know Their Cardiovascular Risks
New ADA Survey Shows Many Know Little About Risks Of Heart Disease, Stroke

August 8, 2001
Diet and Exercise Dramatically Delay Type 2 Diabetes: Diabetes Medication Metformin Also Effective

August 8, 2001
Remarks by HHS Secretary Tommy G. Thompson at Press Conference Announcing Results of Diabetes Prevention Program

 

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