As part of the cancellation of $400 million of federal funding at Columbia University, funding for the Diabetes Prevention Program Outcomes Study (DPPOS) was immediately  terminated by NIH without prior notice on March 10th, 2025. Although Columbia University is the primary recipient of this grant, more than 90% of funds go to research activities at 30 institutions outside of Columbia across 21 states. DPPOS addresses the research priorities related to prevention of diabetes and dementia, highlighted as a priority by the new Secretary of the Department of Health and Human Services.  Persons with pre-diabetes and diabetes, represent over half of the older adult population in the United States, but have not been included in recent advances made in the treatment of Alzheimer’s disease and related dementias. DPPOS addresses this critical need. The DPPOS study cohort is perhaps the largest and longest-running study on lifestyle interventions for diabetes prevention globally. Over 3 decades, the study has demonstrated that diabetes can be prevented or delayed and amassed a wealth of data and stored specimens to answer outstanding public health research questions. The loss of longitudinal data and research infrastructure poses a significant risk to scientific advancements in diabetes prevention and the prevention of Alzheimer’s disease and dementia.

The abrupt cancellation of DPPOS threatens our ability to understand the occurrence of dementias, their causes and potential treatments. The study population with pre-diabetes or diabetes in DPPOS is representative of more than one-half of the older adult population in the US. Importantly, DPPOS focuses on the prevention of chronic disease, a stated objective of the new Secretary of HHS. Every week that goes by results in staff at the 30 centers being laid off, irreparably destroying the DPPOS. With the disruption of the program’s critical research, funds that have already been expended in search of knowledge to improve the health of our country’s population will be wasted as the study will not be completed as planned.

Key facts about DPPOS: 

• The Diabetes Prevention Program (DPP) established that type 2 diabetes can be prevented. The DPP reported in 2001 that the epidemic of diabetes in the US could be reduced by 58% with a lifestyle intervention, which was subsequently adopted by CMS as the Medicare DPP. The results were announced in 2002 at a press conference by Tommy Thompson, the Secretary of the Department of Health and Human Services at the time. The DPP lifestyle program has been endorsed by CDC and is now supported by Medicare.

• The primary manuscript for the DPP trial was published in the New England Journal of Medicine in 2002 and has since been cited more than 26,000 times, the most frequent citation in the diabetes prevention literature. The trial was selected as one of “Drazen’s Dozen” by Jeffrey Drazen, as one of the 12 most impactful studies published during his 19-year tenure as the Editor-in-Chief of the New England Journal of Medicine.

• DPPOS is the decades-long study of type 2 diabetes which continues to follow the original DPP population and is currently examining links between type 2 diabetes and dementia in 1700 participants. The DPPOS has been assessing the long-term effects of the interventions used in the DPP, focusing on the long-term effects of diabetes prevention on other health conditions including cancer, heart disease and stroke, nerve damage, kidney disease and eye disease. Given that the population being studied has been aging and been followed for a prolonged period of time, DPPOS is now focusing heavily on the role of diabetes in Alzheimer’s disease and Alzheimer’s disease-related dementias.

• DPPOS addresses the National Alzheimer’s Project Act goal to “prevent, halt, or reverse Alzheimer’s disease” in the high-risk group of persons with pre-diabetes or type 2 diabetes.

• In 2022, a single award for DPPOS activities was given to Columbia University, from which. However, over 90% of funds are spent outside of Columbia at 30 institutions distributed across the United States.

• DPP Research Group has published over 200 scientific articles, with dozens more under review and in development.

What's Next?

Negotiations to better understand the rationale for the termination and pursuit of means to revive the study are ongoing. Despite the catastrophic news, the DPP research team is valiantly striving to fulfill the obligations to the thousands of patients and researchers who have contributed to the study for three decades and the American people who supported the research effort. All of us deserve answers to these important research questions. DPPOS investigators remain committed to protecting the integrity of this research, preserving our research assets while we continue to advocate for funding to be restored. DPPOS investigators and participants are committed to answering the important research questions related to understanding diabetes complications and the root causes of Alzheimer's disease and related dementias. We will continue to provide updates as the funding situation evolves.