Trial reportDiabetes care2021
Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.
Trial report in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Association of metformin use and cancer incidence: a systematic review and meta-analysis.Journal of the National Cancer Institute · 2024 · on this mapPooled it
- Lower-Intensity Interventions for Prediabetes: A Systematic Review.American journal of preventive medicine · 2023Pooled it
- Effect of metformin on adverse outcomes in T2DM patients: Systemic review and meta-analysis of observational studies.Frontiers in cardiovascular medicine · 2022Pooled it
- Weight Loss Intervention Promoting an Adapted Mediterranean-Style Dietary Pattern: The DELISH Randomized Clinical Trial.JAMA network open · 2026Trial
- Effect of a 1-year supervised exercise intervention on long-term mortality in people with type 2 diabetes.Acta diabetologica · 2026Trial
- Effect of a behavioral counseling for adoption and maintenance of a physically active lifestyle on long-term mortality in people with type 2 diabetes: post hoc analysis of the Italian Diabetes and Exercise Study_2.Nature communications · 2026Trial
- Trial
- The 2018 World Cancer Research Fund/American Institute for Cancer Research Score and Cancer Risk: results from the diabetes prevention program outcomes study.The American journal of clinical nutrition · 2025Trial
- Randomized Study of Metformin and Intensive Lifestyle Intervention on Cancer Incidence over 21 Years of Follow-up in the Diabetes Prevention Program.Cancer prevention research (Philadelphia, Pa.) · 2025 · on this mapTrial
- Association of prediabetes with clinical outcomes in patients with chronic coronary syndrome: a post hoc analysis of the ISCHEMIA and ISCHEMIA-CKD trials.Cardiovascular diabetology · 2024Trial
- Effect of Metformin Versus Placebo on New Primary Cancers in Canadian Cancer Trials Group MA.32: A Secondary Analysis of a Phase III Randomized Double-Blind Trial in Early Breast Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Coronary Artery Calcium and Cognitive Decline in the Diabetes Prevention Program Outcomes Study.Journal of the American Heart Association · 2023Trial
- Trial
- Metformin and Severe Post-COVID-19 Outcomes Among Individuals with Diabetes Mellitus.medRxiv : the preprint server for health sciences · 2026Article
- A cross-sectional analysis of baseline diet quality among participants enrolled in delicious eating for life in the southern homes weight loss randomized trial.Nutrition and health · 2026Article
- [Diabetes mellitus-definition, classification, diagnosis, screening and prevention (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- A robust computational framework for methylation age and disease-risk prediction based on pairwise learning.Nature computational science · 2026Article
- Cardiovascular autonomic dysfunction is linked with arterial stiffness across glucose metabolism: the Maastricht study.BMJ open diabetes research & care · 2026Article
- Six-year Follow-Up of Nonpharmacological and Nonsurgical Obesity Treatments.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Social determinants of health and progression to cardio-renal-metabolic multimorbidity and mortality in people with prediabetes: A prospective cohort study.Diabetes, obesity & metabolism · 2025Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 10 institutions in 1 country.
Funding
Abstract
objectiveTo 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. RESEARCH DESIGN AND
methodsFrom 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.
resultsOver a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death (
conclusionsCancer 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.