Longevity & AgingDiabetes Prevention Lasts 22 Years: Lifestyle Beats Metformin Long-Term
The Diabetes Prevention Program tracked 3,195 adults with prediabetes for 22 years, comparing intensive lifestyle intervention (ILS), metformin, and placebo. Intensive lifestyle reduced diabetes incidence by 24% and metformin by 17% over the full period, translating to median delays in diabetes onset of 3.5 and 2.5 years respectively. The bulk of benefit stemmed from large early reductions during the original 3-year trial. Crucially, effects were heterogeneous: lifestyle worked best in those at highest baseline risk, while metformin showed no benefit—and possibly harm—in older participants. These findings support precision-targeting of preventive interventions toward highest-risk individuals.
