Lifestyle changes such as increased physical activity and healthy eating aimed at reducing weight lost, combined with the anti-diabetic medication metformin, were effective in delaying or preventing type 2 diabetes in adults with prediabetes, new research has found.

The findings of the multicenter Diabetes Prevention Program Outcomes Study were published in the May 23 issue of the American Heart Association’s peer-reviewed journal Circulation.

“We were focused on assessing the impact of lifestyle or metformin interventions for prevention of type 2 diabetes in people with prediabetes to reduce cardiovascular disease,” Ronald B. Goldberg, M.D., chair of the writing group for the study and a professor of medicine, biochemistry and molecular biology in the division of diabetes, endocrinology and metabolism, and senior faculty member and co-director of the Diabetes Research Institute Clinical Laboratory at the University of Miami’s Miller School of Medicine in Miami, said in a news release about the study.

The study evaluated 21 years of follow-up through 2019 of 3,234 racially diverse adults, with an average age of 51, who participated in the original, 3-year Diabetes Prevention Program trial, which ran from 1996-2001.

The study found study participants assigned to the intensive lifestyle intervention group (focused on nutritional improvement and physical activity aimed at achieving a weight loss of 7%) saw a 58% reduction in the incidence of Type 2 diabetes. Meanwhile, participants who took twice daily doses of metformin had a 31% reduced incidence of Type 2 diabetes, when compared to people in the placebo group who received standard care.

Despite the reduction in type 2 diabetes in program participants, the study found no significant differences in the incidence of heart attacks, stroke or cardiovascular death among the three intervention groups.

“These long-term findings confirm the link between type 2 diabetes and cardiovascular disease is complex and requires more research to understand it better,” said Eduardo Sanchez, M.D., M.P.H., FAHA, FAAFP, the American Heart Association’s chief medical officer for prevention, said in the news release. “However, these important results also tell us that lifestyle intervention is incredibly effective to delay or prevent type 2 diabetes, which, itself, reduces the risk for cardiovascular disease.”