US Adults with prediabetes who participated in an intensive lifestyle intervention had a significantly lower risk of developing multiple chronic diseases over 25 years, while metformin did not provide a similar benefit. This long-term follow-up of the Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS) included 1,173 participants with Medicare data available through 2021 (median age 74 years). By the end of follow-up, 85% had developed at least two chronic conditions, but those originally assigned to the lifestyle intervention had a 21% lower risk of multimorbidity compared with the placebo group (HR 0.79), even after accounting for relevant risk factors. The benefit remained when diabetes was excluded from the multimorbidity definition and was even greater for the most costly disease combinations, with a 43% lower risk (HR 0.57). In contrast, metformin was not associated with a significant reduction in multimorbidity. These findings suggest that intensive lifestyle changes, including healthy eating, weight loss, and increased physical activity, may provide lasting protection against the accumulation of chronic diseases in older adults at high risk for diabetes. Source: https://jamanetwork.com/
