@article{001f32e76a15489090cf659290140881,
title = "Does diabetes prevention translate into reduced long-term vascular complications of diabetes?",
abstract = "The global epidemic of type 2 diabetes has prompted numerous studies and public health efforts to reduce its development. A variety of interventions, including lifestyle modifications and pharmacological agents directed at ameliorating the major risk factors for type 2 diabetes, are of proven efficacy in reducing the development of type 2 diabetes in people with impaired glucose tolerance. While prevention of the hyperglycaemia characteristic of diabetes is arguably an important, clinically relevant outcome, a more compelling outcome with greater clinical significance is the prevention or reduction of the relatively diabetes-specific microvascular and less-specific cardiovascular disease (CVD) complications associated with diabetes. These complications cause the majority of morbidity and excess mortality associated with diabetes. Any reduction in diabetes should, logically, also reduce the occurrence of its long-term complications; however, most diabetes prevention trials have not been of sufficient duration to allow such an evaluation. The limited long-term data, largely from the Da Qing Diabetes Prevention Study (DQDPS) and the Diabetes Prevention Program (DPP) and their respective follow-up studies (DQDPOS and DPPOS), suggest a reduction in microvascular complications and amelioration of CVD risk factors. Only the DQDPOS and Study to Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) studies have shown a reduction in CVD events and only DQDPOS has demonstrated a decrease in CVD and overall mortality. While these limited data are promising, whether diabetes prevention directly reduces complication-related morbidity and mortality remains unclear. Longer follow-up of prevention studies is needed to supplement the limited current clinical trial data, to help differentiate the effects of diabetes prevention itself from the means used to reduce diabetes development and to understand the balance among benefits, risks and costs of prevention.",
keywords = "Cardiovascular disease, Cardiovascular disease risk factors, Diabetes prevention, Long-term diabetes complications, Microvascular disease, Review",
author = "{and the DPP Research Group} and Nathan, {David M.} and Bennett, {Peter H.} and Crandall, {Jill P.} and Edelstein, {Sharon L.} and Goldberg, {Ronald B.} and Kahn, {Steven E.} and Knowler, {William C.} and Mather, {Kieren J.} and Sunder Mudaliar and Orchard, {Trevor J.} and Marinella Temprosa and White, {Neil H.}",
note = "Funding Information: The Research Group gratefully acknowledges the commitment and dedication of the participants of the DPP and DPPOS. A complete list of centres, investigators and staff can be found in the electronic supplementary material (ESM). Funding Information: Funding During the DPP and DPPOS, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health provided funding to the clinical centres and the Coordinating Center for the design and conduct of the study and collection, management, analysis and interpretation of the data (U01 DK048489). The Southwestern American Indian Centers were supported directly by the NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources and the Department of Veterans Affairs supported data collection at many of the clinical centres. Funding was also provided by the National Institute of Child Health and Human Development, the National Institute on Aging, the National Eye Institute, the National Heart Lung and Blood Institute, the National Cancer Institute, the Office of Research on Women{\textquoteright}s Health, the National Institute on Minority Health and Health Disparities, the Centers for Disease Control and Prevention and the American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during the DPP. Lipha (Merck-Sante) provided medication and LifeScan Inc. donated materials during the DPP and DPPOS. This research was also supported, in part, by the intramural research program of the NIDDK. LifeScan Inc., Health O Meter, Hoechst Marion Roussel, Inc., Merck-Medco Managed Care, Inc., Merck and Co., Nike Sports Marketing, Slim Fast Foods Co. and Quaker Oats Co. donated materials, equipment or medicines for concomitant conditions. McKesson BioServices Corp., Matthews Media Group, Inc. and the Henry M. Jackson Foundation provided support services under subcontract with the Coordinating Centre. The sponsor of this study was represented on the Steering Committee and played a part in study design, how the study was done and publication. The funding agency was not represented on the writing group, although all members of the Steering Committee had input into the report{\textquoteright}s contents. The opinions expressed are those of the investigators and do not necessarily reflect the views of the funding agencies. Publisher Copyright: {\textcopyright} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",
year = "2019",
month = aug,
day = "1",
doi = "10.1007/s00125-019-4928-8",
language = "English (US)",
volume = "62",
pages = "1319--1328",
journal = "Diabetologia",
issn = "0012-186X",
publisher = "Springer Verlag",
number = "8",
}
