The Diabetes Prevention Program (DPP), funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and conducted at 27 centers nationwide, was a landmark trial to show that lifestyle changes or metformin can effectively delay diabetes in a diverse population of overweight or obese American adults at high risk of diabetes in the short term and long term compared to placebo. 

The public health implications of T2D and the high-risk state of Pre-DM cannot be over-stated, with estimated prevalence of ~25 and ~79 million, respectively. Type 2 diabetes is the main cause of kidney failure, limb amputations, and new onset blindness in adults and a major cause of heart disease and stroke. Type 2 diabetes, which accounts for up to 95 percent of all diabetes cases, becomes more common with increasing age. The prevalence of diagnosed diabetes has more than doubled in the last 30 years, due in large part to the upsurge in obesity.  

The goal of DPPOS was to study whether the relatively short-term benefits of delaying diabetes demonstrated in the DPP would translate into long-lasting impact. DPPOS had the following major goals, to determine the effect of DPP interventions on: 1) durability of T2D development; 2) early microvascular disease (nerve damage and kidney disease); and 3) atherosclerosis and cardiovascular disease risk factors. 

As participants age, we have shifted our focus to age-related health problems such as trouble with physical function and difficulties with thinking or memory. Thus, the main goal of the current of DPPOS is to address one of the most important, complex questions in Alzheimer’s disease (AD) and Alzheimer’s disease-related dementias (ADRD) research: What are the determinants and the nature of cognitive impairment among persons with pre-diabetes and type 2 diabetes, who are a high-risk group for cognitive impairment and represent a large fraction of the United States population?

For protocol and more details, see About DPP and About DPPOS.  For clinical trials.gov information, go to the DPP, DPPOS, and DPPOS-4 listings. For study questions, please contact the Coordinating Center here.