Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2006 Oct;61(10):1075-81.
doi: 10.1093/gerona/61.10.1075.

The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes

Diabetes Prevention Program Research Group  1 ; Jill Crandall, David Schade, Yong Ma, Wilfred Y Fujimoto, Elizabeth Barrett-Connor, Sarah Fowler, Sam Dagogo-Jack, Reubin Andres
Affiliations
Randomized Controlled Trial

The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes

Diabetes Prevention Program Research Group et al. J Gerontol A Biol Sci Med Sci. 2006 Oct.

Abstract

Background: The incidence of type 2 diabetes increases with age. It is unknown whether interventions to prevent diabetes are as effective in elderly persons as in younger adults.

Methods: The Diabetes Prevention Program (DPP) demonstrated that an intensive lifestyle intervention (ILS) or metformin could prevent or delay diabetes. A predefined secondary outcome of DPP was to determine if treatment effects varied by age.

Results: At baseline, participants aged 60-85 years were leaner and had the best insulin sensitivity and lowest insulin secretion compared to younger age groups. Diabetes incidence rates did not differ by age in the placebo group, but ILS was more effective with increasing age (6.3, 4.9, and 3.3 cases per 100 person-years, in the 25-44, 45-59, and 60-85 year age groups, respectively; p(trend) =.007). Participants aged 60-85 years had the most weight loss and metabolic equivalent (MET)-hours of physical activity. The metformin group showed a trend toward higher diabetes incidence among older participants (6.7, 7.7, and 9.3 cases per 100 person-years in the 25-44, 45-59, and 60-85 year age groups, respectively; p(trend) =.07); and diabetes risk increased with age (hazard ratio [age 60-85 vs 25-44] 1.63, p =.02), after adjusting for the greater weight loss in the 60-85 year age group.

Conclusions: Lifestyle modification was exceptionally effective in preventing diabetes in older individuals; this finding was largely explained by greater weight loss and physical activity. The limited effectiveness of metformin in older persons may reflect age-related differences in insulin action and secretion. A lifestyle modification program can be recommended for older individuals at high risk for type 2 diabetes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Diabetes incidence rate by age and treatment group.
See this image and copyright information in PMC

References

    1. Diabetes Prevention Program Research Group Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403. - PMC - PubMed
    1. Harris M, Flegal K, Cowie C, et al. Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey. Diabetes Care. 1998;21:518–524. - PubMed
    1. Resnick H, Harris M, Brock D, Harris T. American Diabetes Association diabetes diagnostic criteria, advancing age and cardiovascular disease risk profiles. Diabetes Care. 2000;23:176–180. - PubMed
    1. Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. Diabetes Care. 1998;21:1236–1239. - PubMed
    1. Balkau B. New diagnostic criteria for diabetes and mortality in older adults. Lancet. 1999;353:68–69. - PubMed

Publication types