Lifestyle intervention enough to reduce multimorbidity risk in adults with prediabetes

In adults with prediabetes, lifestyle interventions may help reduce the development of chronic conditions, according to a study.

The study included 1,173 adults with prediabetes (median age 74 years, 68 percent female) who participated in the 3-year Diabetes Prevention Program (DPP) and were subsequently enrolled in the DPP Outcomes Study (DPPOS).

The participants were randomly assigned to undergo intensive lifestyle intervention or receive metformin treatment or placebo. During DPPOS, medications were unmasked, with placebo discontinued. Group booster classes were provided to the lifestyle group semiannually, and all participants were offered lifestyle classes quarterly.

The primary outcome was multimorbidity, defined as the presence of at least two of 15 prevalent conditions. Over a follow-up of 21 years, multimorbidity occurred in 82 percent, 85 percent, and 87 percent of patients in the lifestyle, metformin, and placebo groups, respectively.

Compared with placebo, lifestyle intervention reduced the risk multimorbidity by 21 percent (hazard ratio [HR], 0.79, 95 percent confidence interval [CI], 0.68–0.93). Metformin showed no association with the risk of multimorbidity compared with placebo (HR, 0.91, 95 percent CI, 0.78–1.07). These associations persisted when diabetes was excluded from the multimorbidity definition.

In an analysis restricted to dyads of the costliest conditions, the risk of multimorbidity with lifestyle vs placebo was reduced by 43 percent (HR, 0.57, 95 percent CI, 0.38–0.85).