Diabetes Clinical Trial
Official title:
The Indian Diabetes Prevention Programme Shows That Lifestyle Modification and Metformin Prevent Type 2 Diabetes in Asian Indian Subjects With Impaired Glucose Tolerance (IDPP1)
Three year prospective randomised controlled trial in IGT subjects to study the effect of metformin and lifestyle modification in preventing the conversion to diabetes
Lifestyle modification helps in primary prevention of diabetes in multiethnic Americans,
Finnish and Chinese populations. In a prospective community based study, we tested if the
conversion to diabetes could be influenced by interventions in native Asian Indians with
impaired glucose tolerance (IGT) who were younger, leaner and more insulin resistant than
the above populations.
We randomized 531 (Men : Women, 421 : 110) subjects with IGT [mean age of 45.9 + 5.7 years
and body mass index (BMI) of 25.8 + 3.5 kg/m2 into four groups. Group 1 was the control
(CON), Group 2 was advised lifestyle modification (LSM), Group 3 was treated with metformin
(MET) and Group 4 with LSM plus MET. Primary outcome measure was type 2 diabetes diagnosed
by the WHO criteria.
In a median follow up of 30 months, three year cumulative incidence of diabetes were 55.0%,
39.3%, 40.5% and 39.5% in group 1 to 4 respectively. The relative risk reduction was 28.5%
with LSM (95 % confidence interval (CI), (20.5 - 37.3), (p=0.018), 26.4% with MET (95% CI,
19.1 - 35.1) (p = 0.029) and 28.2% with LSM plus MET (95% CI, 20.3 - 37.0), (P=0.022) versus
control group. The numbers needed to treat to prevent one incident case of diabetes were 6.4
for LSM, 6.9 for MET and 6.5 for LSM+MET.
Conversion of IGT to diabetes is high in native Asian Indians. LSM and metformin
significantly reduced the incidence of diabetes in Asian Indians with IGT. There was no
added benefit by combining both.
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Allocation: Randomized, Masking: Open Label, Primary Purpose: Prevention
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