Evidence map›Paper›PMID 26024851›Full record

Trial reportPreventive medicine2015

The comparative efficacy of lifestyle intervention and metformin by educational attainment in the Diabetes Prevention Program.

Matthew J O'Brien, Robert C Whitaker, Daohai Yu, Ronald T Ackermann

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Preventive medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.

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  10. Meta-Analysis of the Effect of Metformin on the Progression of Different Types of Prediabetes Mellitus.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Matthew J O'BrienDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg, School of Medicine, 750N. Lake Shore Drive, 10th floor, Chicago, IL 60611, USA; Center for Community Health, Institute for Public Health and Medicine, Northwestern, University Feinberg School of Medicine, 750N. Lake Shore Drive, 6th floor, Chicago, IL 60611, USA. Electronic address: matthew.obrien1@northwestern.edu.
Robert C WhitakerDepartment of Public Health, Temple University, 1938 Liacouras Walk, Philadelphia, PA 19140, USA; Department of Pediatrics, Temple University School of Medicine, 3500N. Broad Street, Philadelphia, PA, 19140, USA; Center for Obesity Research and Education, Temple University, 3223N. Broad Street, Suite, 175, Philadelphia, PA, 19140, USA. Electronic address: bobwhit@temple.edu.
Daohai YuDepartment of Clinical Sciences, Temple University School of Medicine, 3500N. Broad Street, Philadelphia, PA, 19140, USA. Electronic address: dyu@temple.edu.
Ronald T AckermannDivision of General Internal Medicine and Geriatrics, Northwestern University Feinberg, School of Medicine, 750N. Lake Shore Drive, 10th floor, Chicago, IL 60611, USA; Center for Community Health, Institute for Public Health and Medicine, Northwestern, University Feinberg School of Medicine, 750N. Lake Shore Drive, 6th floor, Chicago, IL 60611, USA. Electronic address: r.ackermann@northwestern.edu.
Northwestern University · USTemple University · US

Funding

Promotora-Led Intervention to Promote Weight Loss in Latinas at-risk for DiabetesK23DK095981 · NIDDK · TEMPLE UNIV OF THE COMMONWEALTH · PI O'BRIEN, MATTHEW JAMES · 2012 to 2016
$890k
NIDDK NIH HHS K23 DK095981NIDDK NIH HHS K23-DK095981
6 · The paper itself

Abstract

objectiveEducational attainment is inversely associated with type 2 diabetes risk, but it is unknown whether education impacts individuals' diabetes prevention efforts. We examined the comparative efficacy of intensive lifestyle intervention and metformin by educational attainment among participants in the Diabetes Prevention Program (DPP), an ongoing U.S. multi-site trial beginning in 1996.

methodsWe studied 2,910 DPP participants randomized to receive lifestyle intervention, metformin, or placebo. Stratifying by educational attainment, diabetes incidence and relative risk reductions by treatment assignment were estimated using Cox proportional hazards regression.

results47% of participants had completed college and 53% had not. Compared to placebo, lifestyle participants who had completed college demonstrated a 68% reduction in diabetes incidence (95% CI=56, 77), whereas those with less education experienced a 47% risk reduction (95% CI=29, 61). For metformin participants, college graduates experienced a 49% relative risk reduction (95% CI=33, 62), compared to 23% (95% CI=1, 41) among those with lower educational attainment. There was a statistically significant education-by-treatment interaction with incident diabetes (p=0.03).

conclusionsIntensive lifestyle intervention and metformin have greater efficacy among highly educated individuals. Future efforts to deliver these treatments and study their dissemination may be more effective if tailored to individuals' educational background.

Indexed as

Educational StatusLife StyleAdultDiabetes Mellitus, Type 2ExerciseFemaleHealth PromotionHumansHypoglycemic AgentsMaleMetforminMiddle AgedRandom AllocationRisk Reduction BehaviorSocial ClassUnited StatesHypoglycemic AgentsMetforminDiabetes preventionEducational attainmentLifestyle interventionMetforminSocioeconomic status

Identifiers

PMID26024851
PMCPMC4490008
OpenAlexW1766032349

What OpenQuestion holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.