The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index; 6 of the 22 sources its claims cite were checked for support.
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study
Open accessAbstract
Background In the 2.8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term. Methods All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5.7 years (IQR 5.5-5.8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727. Findings During the 10.0-year (IQR 9.0-10.5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4.8 cases per 100 person-years (95% CI 4.1-5.7) in the intensive lifestyle intervention group, 7.8 (6.8-8.8) in the metformin group, and 11.0 (9.8-12.3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5.9 per 100 person-years (5.1-6.8) for lifestyle, 4.9 (4.2-5.7) for metformin, and 5.6 (4.8-6.5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24-42) in the lifestyle group and 18% (7-28) in the metformin group compared with placebo. Interpretation During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years. Funding National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
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Claims the paper makes
29 Own result · 16 Own interpretation · 14 Own method · 7 No full text of the sources · 3 Not checked yet · 2 Partly supported · 2 No basis given · 1 Supported · 1 Supported so far · 1 Not supported · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“intensive lifestyle intervention or metformin prevented or delayed development of type 2 diabetes in adults at high risk because of raised fasting plasma glucose (5·3–6·9 mmol/L), impaired glucose tolerance (2-h postload glucose 7·8–11·0 mmol/L), and body-mass index of 24 kg/m2 or higher (≥22 kg/m2 in Asian Americans).3,4”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Introduction
What the sources say
- Partly supportedcites [3] 1999, The Diabetes Prevention Program: design and methods for a clinical trial in the prevention of type 2 diabetes mellitus, Diabetes Care sourceExperimental — accuracy not yet measured
The Abstract and Study Design eligibility criteria describe the DPP’s lifestyle and metformin arms and the high-risk participants, including the stated glucose and BMI thresholds. But this 1999 design-and-methods paper says the trial will test whether the interventions prevent or delay diabetes; it does not report that they did so. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [4] 2002, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Our findings that both lifestyle and metformin interventions delayed or prevented diabetes in the DPPOS are consistent with results of other reports of similar interventions with lifestyle or with other antidiabetic drugs.24,25”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [24] Crandall, 2008, The prevention of type 2 diabetes, Nat Clin Pract Endocrinol Metab source
- Supportedcites [25] Gillies, 2007, Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis, BMJ source
The Quantitative data synthesis reports reduced diabetes risk with both lifestyle interventions and oral diabetes drugs. The Conclusions likewise state that both types of intervention significantly reduced progression to type 2 diabetes in people with impaired glucose tolerance. This supports the cited comparison with other reports; the DPPOS finding is the citing authors’ own result, not a finding attributed to this review. (LLM, conf=0.93)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The DPP and other clinical trials12–16 have established the feasibility of interruption of the worsening of hyperglycaemia in overweight people who have raised fasting or postload glycaemia.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [12] Pan, 1997, Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study, Diabetes Care source
- Supportedcites [13] Tuomilehto, 2001, Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance, N Engl J Med source
This paper is one of the other clinical trials cited alongside the DPP. The Study Design section describes overweight participants with impaired postload glucose tolerance, and the Results report greater reductions in fasting and two-hour postload glucose in the intervention group than in controls. Its findings support the feasibility of interrupting worsening hyperglycaemia in that population. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [14] Chiasson, 2002, Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomized trial, Lancet source
- Not checked — no full text of the sourcecites [15] 2006, Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial, Lancet source
- Partly supportedcites [16] Ramachandran, 2006, The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1), Diabetologia sourceExperimental — accuracy not yet measured
The Discussion reports that lifestyle modification and metformin reduced progression from impaired glucose tolerance to diabetes in native Asian Indian subjects, supporting the feasibility claim for people with raised postload glucose. The Population and recruitment section defines that glucose criterion, but the trial did not require participants to be overweight; the Discussion gives a mean BMI of 25.8, not an overweight-only result. (LLM, conf=0.82)
boosteddirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During DPPOS, diabetes incidence rates did not significantly differ between groups (table 3).”
- Also stated in: § Discussion · plain
“Diabetes incidence during the DPPOS did not differ significantly between the three randomised groups.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in both the metformin and placebo groups who were aged 60–85 years at DPP randomisation lost weight (figure 2).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants younger than 45 years at randomisation had less sustained weight loss from randomisation throughout the DPPOS than did those aged 45 years and older.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In each sex and treatment group, attendance was roughly twice as high in those aged 60–85 years at randomisation than in those aged 25–44 years.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The placebo group’s mean weight loss was less than 1 kg from DPP entry.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With a definition of normoglycaemia of fasting glucose less than 5·6 mmol/L,11 2-h glucose less than 7·8 mmol/L, and no previous diagnosis of diabetes, the corresponding frequencies were 13%, 11%, and 10%.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Median follow-up from randomisation in the DPP to the most recent assessment in the DPPOS was 10·0 years (IQR 9·0–10·5).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 10
- It may state two separate claims as one. 39
- The quote only partly states this claim. 1
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“For example, in the non-surgical treatment group of the Swedish Obese Subjects Study21 of bariatric surgery, a 0·1% weight gain was reported, on average, after 10 years.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Disputedcites [21] Sjöström, 2004, Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery, N Engl J Med sourceExperimental — accuracy not yet measured
The Abstract reports a 0.1% weight gain in the control group after two years, not ten. At ten years, it reports a 1.6% weight gain in that group. (LLM, conf=0.95)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“The delay in median time to diabetes diagnosis was previously estimated to be 11 years for the lifestyle and 3 years for the metformin groups on the basis of extrapolation of DPP incidence.19”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Supportedcites [19] 2005, The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance, Ann Intern Med source
The Results (Base-Case Analysis) estimate that 50% of the DPP cohort would develop diabetes after approximately 7 years with placebo, 18 years with lifestyle intervention, and 10 years with metformin—delays of 11 and 3 years. The Methods (Disease Progression) state that the model used DPP data to assess diabetes-onset hazards. (LLM, conf=0.94)
hedgeddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The metformin group lost a mean of 2·5 kg during DPP and maintained most of that weight loss.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lifestyle group subsequently regained about 1 kg, whereas the metformin and placebo groups initially lost and then regained weight back to their respective levels at DPPOS baseline (figure 2).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lifestyle effect was greatest in participants aged 60–85 years at randomisation (49% rate reduction), in whom metformin had no significant effect (figure 3).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HbA1c and fasting glucose concentrations were lower in the metformin and lifestyle groups than in the original placebo group, despite more people in the placebo group using antidiabetic drugs than those in the metformin (excluding study-assigned metformin) or lifestyle groups.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Averaged over all follow-up, systolic and diastolic blood pressure and triglycerides were lower in the lifestyle than in the other groups, although use of anti-hypertensive drugs was less frequent.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lifestyle group participants initially lost the most weight (a mean of 7 kg by 1 year), but gradually regained, although still weighing about 2 kg less than they did at randomisation.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the 10·0-year (IQR 9·0–10·5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24–42) in the lifestyle group and 18% (7–28) in the metformin group compared with placebo.”
- Also stated in: § Results · plain
“During the combined DPP, bridge, and DPPOS periods, the incidence rate of the lifestyle group was reduced by 34% (95% CI 24–42) and metformin by 18% (7–28) compared with placebo.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Findings
plaindirect- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During this study, cumulative incidence curves for the 1994 participants who remained without diabetes on Sept 1, 2002, (five of the original 1999 had no follow-up) did not continue to separate as they had in DPP, because the accumulation of additional cases of diabetes was similar in the three groups (figure 3).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plainn = 1,994- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetes incidence rates during the DPP were 4·8 cases per 100 person-years (95% CI 4·1–5·7) in the intensive lifestyle intervention group, 7·8 (6·8–8·8) in the metformin group, and 11·0 (9·8–12·3) in the placebo group.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the most recent yearly examination, 23% in the lifestyle, 19% in the metformin, and 19% of participants in the placebo groups had become normoglycaemic by criteria defined and reported previously (fasting glucose <6·1 mmol/L, 2-h glucose <7·8 mmol/L, and no previous diagnosis of diabetes).4,5”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Incidence rates were stable in the lifestyle group, but fell in the placebo and metformin groups during the DPPOS.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, systolic and diastolic blood pressure and triglycerides were lower in the lifestyle than in the metformin and placebo groups, but these differences were not maintained by the end of follow-up (table 4).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This point was delayed by about 4 years by lifestyle and 2 years by metformin, compared with placebo.”
- Also stated in: § Discussion · plain
“In this study, onset of diabetes was delayed by about 4 years by lifestyle intervention and 2 years by metformin compared with placebo.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaindirect- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lifestyle intervention also resulted in improved blood pressure and lipid concentrations despite a reduction in drug treatment prescribed by participants’ personal physicians.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Attendance at BOOST sessions for the original lifestyle group averaged 17% (19% for participants without diabetes), and was positively associated with age.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The two groups newly exposed to lifestyle intervention (metformin and placebo) had higher attendance than did the lifestyle group during the bridge period, and they achieved modest weight loss, although less than the lifestyle group did during the DPP.8”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Interpretation
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“During DPPOS, 57% of the non-diabetic metformin participants took 80% or more of the prescribed metformin dose and 70% took metformin in any amount, compared with 1% of non-diabetic participants in the lifestyle group and 3% in the original placebo group who took metformin prescribed outside the study.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Enrolment into this follow-up study from the DPP cohort did not differ significantly by sex or ethnic origin, but was lower in women with a history of gestational diabetes than in those without and higher in participants who had developed diabetes by Sept 1, 2002, than in those without diabetes (table 1).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Each analysis of change from the start of DPPOS was adjusted for the study’s baseline value, and each analysis of change from DPP randomisation until the analysis closing date was adjusted for the DPP baseline value.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Enrolment was also related to greater age, HbA1c, cholesterol concentrations, and in women, by lower weight and body-mass index (webappendix p 1).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years.”
- Also stated in: § Discussion · boosted
“Our results have shown that a reduction in diabetes cumulative incidence by either lifestyle intervention or metformin therapy persists for at least 10 years.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Interpretation
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Discussion · boosted
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did three pair-wise comparisons of diabetes incidence in the three intervention groups, each at an α of 0·017—ie, the conventional 0·05 adjusted for three comparisons.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“2766 of 3150 (88%) enrolled for a median additional follow-up of 5·7 years (IQR 5·5–5·8).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Methods
plainn = 3,150- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Analysis was by intention-to-treat.”
- Also stated in: § Statistical analysis · plain
“The intention-to-treat analysis compared each intervention with placebo on a modified product-limit life-table distribution with a log-rank test statistic.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Methods
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
- Also stated in: § Statistical analysis · plain
In the paper
“diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo.”
- Also stated in: § Participants · plain
“lifestyle intervention reduced incidence of diabetes by 58% and metformin by 31% compared with placebo during an average of 2·8 years in the DPP.4”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Abstract > Background
What the sources say
- Not checked — no full text of the sourcecites [4] 2002, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
- Also stated in: § Participants · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The metformin and placebo groups were masked (double blind) to treatment.3,4,6”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Methods > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Attendance at quarterly lifestyle sessions (HELP) averaged 18% for the original lifestyle group, 15% for the metformin group, and 14% for the placebo group (20%, 15%, and 14%, respectively, in non-diabetic participants).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lifestyle and metformin interventions succeeded in producing long-term (10-year) weight loss.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Limitations of the present analyses include the less than complete enrolment in our study and the treatment modifications after the end of DPP.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, convergence of diabetes incidence rates in the three treatment groups during the bridge and DPPOS might be a result of either a diminished effect of the lifestyle intervention for the original lifestyle group compared with the intensive lifestyle intervention during the DPP, or the introduction of group-implemented lifestyle intervention to the DPP placebo and metformin groups, or both.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The present estimated delays are smaller than the original estimates owing largely to the reduction in diabetes incidence in the placebo group.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the change in ascertainment of diabetes over time complicates data interpretation.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This finding was not attributable to a rebound effect in the lifestyle group but to a fall in incidence in the placebo and metformin groups that resulted in similar rates as achieved by lifestyle intervention, which changed little throughout follow-up (table 3 and figure 4).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“10 years after DPP randomisation, cumulative incidence of diabetes remained lower in the lifestyle and metformin groups than in the placebo group, despite changes in treatments after a mean of 3·2 years.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Cumulative data are completely contained within the other separately reported periods, statistically provide no additional information, and do not represent a predesigned uniform intervention over time. Therefore, significance tests or CIs reported for the entire time since randomisation should be interpreted cautiously.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“After 6 years of treatment, cumulative diabetes incidences were high (68% in usual care, 48% in diet, 41% in exercise, and 46% in diet plus exercise groups), with all three interventions being similarly effective.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [12] Pan, 1997, Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study, Diabetes Care source
- Not checked — no full text of the sourcecites [26] Li, 2008, The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study, Lancet source
plainn = 577- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the intervention was not actively delivered during the 3-year follow-up, it remained effective with a 39% reduction in incidence.18”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [18] Lindström, 2006, Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These factors probably contributed to greater weight loss (figure 2) and protection from diabetes in the older than in the younger participants, particularly in the lifestyle group (figure 3).”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, diabetes complications were too infrequent for analysis of treatment effects, and the full DPPOS follow-up will be needed to assess whether prevention or delay of diabetes onset will have the same effect on complications.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As far as we know, no long-term follow-up of drug intervention to prevent diabetes has been published except for the DPPOS.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, this hypothesis is not supported by stability over time of diabetes incidence in the lifestyle group, by findings in high-risk Pima Indians, in whom the yearly incidence of diabetes in people with impaired glucose tolerance increased rather than decreased during a 10-year follow-up,17 or by results of the Finnish Diabetes Prevention Study18 in which diabetes incidence in the control group”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
What the sources say
- Not checked — no full text of the sourcecites [17] Saad, 1988, The natural history of impaired glucose tolerance in the Pima Indians, N Engl J Med source
- Not checked — no full text of the sourcecites [18] Lindström, 2006, Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Because diabetes is defined by somewhat arbitrary cut-off points of hyperglycaemia, arrest of progression of hyperglycaemia prevents or delays onset of diabetes.”
§ 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
The authors state this as an assumption.
Preventing or delaying diabetes as defined by conventional glycaemic thresholds would also prevent or delay clinical complications such as microvascular and macrovascular disease and neuropathy.
“one might assume that prevention or delay of onset of diabetes as defined by conventional glycaemic cut-offs would also prevent or delay these clinical manifestations.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Diabetes Prevention Program Outcomes Study34 reported 10 years of follow-up of a lifestyle weight-loss intervention, but both the lifestyle group and the comparison groups received weight loss counseling after a mean of 3.2 years since randomization.”
From Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study (2014) · cites this paper as [34]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Sustaining weight loss for longer periods may further improve the prevention of type 2 diabetes in at-risk individuals,34 as well as maintain improvements in sleep apnea,5 physical mobility,6 and other health conditions ameliorated by weight loss.7–9”
From Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study (2014) · cites this paper as [34]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Of the 3150 eligible surviving DPP participants, 88% enrolled in DPPOS with similar baseline characteristics in each treatment group (88% of each sex and 87 to 88% of each treatment group enrolled).6”
From Long-term effects and effect heterogeneity of lifestyle and metformin interventions on type 2 diabetes incidence over 21 years in the US Diabetes Prevention Program randomised clinical trial (2025) · cites this paper as [6]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Previous studies of lifestyle interventions for diabetes prevention, such as the Diabetes Prevention Program, have demonstrated sustained benefits over 2.9 to 6 years, with continued protection of 27–43% for up to 15 years38.”
From Impact of digital health interventions on glycemic control and weight management. (2025) · cites this paper as [38]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The DPP (1996-2001) was a multicenter (27 centers), randomized controlled clinical trial designed to determine whether treatment with lifestyle intervention or metformin could prevent or delay type 2 diabetes in high-risk adults.”
From The impact of physical activity on the prevention of type 2 diabetes: Evidence and lessons learned from the Diabetes Prevention Program, a long-standing clinical trial incorporating subjective and objective activity measures (2021) · cites this paper as [2]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“participants received intensive, CBT-based lifestyle counseling reinforced through periodic “booster” sessions focused on dietary logging and activity tracking, sustaining partial weight loss and delaying diabetes onset for over a decade”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [86]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Evidence from long-term lifestyle programs demonstrates that integrating dietary modification, structured exercise, and behavioral counseling achieves greater adherence and durability than any single component alone.53,86”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [86]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Intensive Behavioral Counseling (IBC) interventions like the National Diabetes Prevention Program (NDPP), have demonstrated effectiveness in reducing excess body weight and lowering or delaying morbidity onset.”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Intensive Behavioral Counseling (IBC) has been widely accepted as an effective approach for compliant individuals to reduce body weight, improve clinical measures, and lower risk of obesity-related comorbidities [1–6].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Furthermore, the 10- and 15-year follow-up studies continued to show reduced incidence of diabetes by 34% and 27%, respectively, relative to the control group [1,2].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“and imply that the relative risk reductions seen in NDPP/DPPOS may be higher than what would be expected in a larger population [1,2].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity (in the form of higher labor force participation and lower work absenteeism) [1–6,13–15,19].”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“pivotal randomized trials of GLP-1 RAs for obesity (STEP, SURMOUNT, SCALE) all incorporated intensive lifestyle interventions modeled on Diabetes Prevention Program-style curricula, and the magnitude of weight loss in the control arms of these trials confirms that structured lifestyle support produces clinically meaningful effects in this population even without GLP-1 RA therapy [9,13,76,77].”
From Adherence and Persistence with GLP-1-Based Therapies: International Real-World Evidence and the Role of Nutritional and Lifestyle Support—A Narrative Review (2026) · cites this paper as [76]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A clear definition is limited by the interpretation of blood glucose levels itself as these change considerably over time [12].”
From Optimal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) Cut-Offs: A Cross-Sectional Study in the Czech Population (2019) · cites this paper as [12]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Some of their weight loss, however, probably was attributable to the combined effects of diabetes36 and aging, since it also occurred in older participants in Look AHEAD’s DSE group and in the original placebo-treated group of the Diabetes Prevention Program Outcomes Study.34”
From Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study (2014) · cites this paper as [34]
The cited source says what the claim attributes to it.
In the citing paper
“though as seen in the diabetes prevention program outcomes study, cardiometabolic benefits may be preserved despite weight regain [153].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [153]
The cited source says what the claim attributes to it.
In the citing paper
“The strongest evidence for type 2 diabetes prevention comes from several studies, including the DPP (26 -28).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [28]
The cited source says what the claim attributes to it.
In the citing paper
“During an average 10 years of follow-up since DPP randomization, the between-group differences in cumulative diabetes incidence persisted, although to a lesser degree than at DPP end (2).”
The cited source says what the claim attributes to it.
In the citing paper
“The incidence of diabetes was reduced in the lifestyle intervention and metformin arms compared with placebo by 58% and 31%, respectively, after a mean of 2.8 years of follow-up during the masked treatment phase.”
The cited source says what the claim attributes to it.
In the citing paper
“Diabetes incidence rates were similar between treatment groups: 5.9 per 100 person-years (5.1–6.8) for lifestyle, 4.9 (4.2–5.7) for metformin, and 5.6 (4.8–6.5) for placebo.”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [11]
The cited source says what the claim attributes to it.
In the citing paper
“The Diabetes Prevention Program (DPP) lifestyle intervention is the criterion standard for reducing the risk of diabetes in individuals with prediabetes, demonstrating 58% risk reduction over 3 years.5,6”
From An AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program: A Randomized Clinical Trial (2025) · cites this paper as [5]
The cited source says what the claim attributes to it.
In the citing paper
“34% reduction at 10 years (28) and 27% reduction at 15 years extended followup of the DPP (31) in the U.S. Diabetes Prevention Program Outcomes Study (DPPOS).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [28]
The cited source says what the claim attributes to it.
In the citing paper
“The most successful weight-loss trials to date—including the STEP program for semaglutide [9] and the SURMOUNT program for tirzepatide [13]—have incorporated intensive lifestyle interventions as a core component of the trial protocol, modeled on the structured behavioral curricula pioneered by the Diabetes Prevention Program (DPP) [76,77].”
From Adherence and Persistence with GLP-1-Based Therapies: International Real-World Evidence and the Role of Nutritional and Lifestyle Support—A Narrative Review (2026) · cites this paper as [76]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The DASH diet has been shown to reduce BP and is particularly effective in individuals who were hypertensive at baseline and/or self-identified as African American.817,818”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [818]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“These lower estimates were calculated based on published estimates of diabetes incidence from the CDC”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“For the population with an average BMI ≥27 and at least one additional risk factor (hypertension, type 2 diabetes, and/or dyslipidemia), Thorpe et al. projected that 10% sustained weight loss could generate $8,648 (inflated to 2015 USD) in direct medical savings over 10 years.”
From Clinical and Economic Impact of a Digital, Remotely-Delivered Intensive Behavioral Counseling Program on Medicare Beneficiaries at Risk for Diabetes and Cardiovascular Disease (2016) · cites this paper as [2]
Experimental — accuracy not yet measuredIn the citing paper
“In more recent major studies, progression estimates have been similar: the annualised incidence was 11% in the Diabetes Prevention Program (DPP) Outcomes Study,15 6% among participants with IFG in the US Multi-Ethnic Study of Atherosclerosis (MESA),16 9% among participants with IFG and 7% among those with an A1c 5.7–6.4% in a Japanese population-based study.17”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [15]
In the citing paper
“Several trials have demonstrated reductions in the risk of developing diabetes among prediabetic individuals after lifestyle and drug-based interventions.15,24–28”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [15]
In the citing paper
“Other studies have reported lower conversion rates29 (19% in controls in the DPP Outcomes study).15”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [15]
In the citing paper
“Several trials support a long-term reduction in diabetes risk or a delay in the onset of the disease as a result of lifestyle and drug-based interventions.15,19,116–118”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [15]
In the citing paper
“diabetes can be prevented in high-risk obese adults with impaired glucose tolerance through diet and exercise interventions [692,693].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [693]
In the citing paper
“More than 50% reductions in depression scores were also observed over 3 times more often in the CC treatment group compared to control condition (OR 3.37; 95% CI 1.84 -6.17), alongside improved perceived self-efficacy, and greater patient satisfaction with medical care.[361][362][363]”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [362]
In the citing paper
“Moreover, follow-up of 3 large studies of lifestyle intervention for diabetes prevention has shown sustained reduction in the rate of conversion to T2DM: 43% reduction at 20 years in the Da Qing Diabetes Prevention Study [134]; 43% reduction at 7 years in the Finnish Diabetes Prevention Study [135] and 34% reduction at 10 years [132], and 27% reduction at 15 years extended follow-up in the DPP [”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [132]
In the citing paper
“Several trials that examined the efficacy of multi-component lifestyle interventions have demonstrated tremendous benefits on reducing T2D risk and improving cardiovascular health among high-risk individuals (7–12), although the long-term benefits on reducing CVD events among diabetic patients were less established (6).”
From Influence of lifestyle on incident cardiovascular disease and mortality in patients with diabetes mellitus (2018) · cites this paper as [7]
In the citing paper
“After a median of 10 years of follow-up since DPP randomization, both the lifestyle and metformin intervention groups had significantly less diabetes than the placebo group (6).”
From Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study (2012) · cites this paper as [6]
In the citing paper
“Weight loss in the metformin group was maintained throughout the combined DPP and DPPOS period with metformin participants having an average 2.5-kg weight loss over time (6).”
From Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study (2012) · cites this paper as [6]
In the citing paper
“Diabetes incidence 10 years since DPP randomization was reduced by 34% and 18% in the lifestyle and metformin group, respectively [11] (Table 1).”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [11]
In the citing paper
“Follow-up of the DPP cohort for 10 years after randomization showed ongoing greater impact of the original lifestyle intervention in older participants (49% risk reduction in those over age 60 years at randomization vs. 34% for the total cohort)19”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [19]
In the citing paper
“In the Diabetes Prevention Program (DPP), the annual incidence of diabetes in patients with IGT was 11% in the control group.”
From The Vasculature in Prediabetes (2018) · cites this paper as [18]
In the citing paper
“At ten years, the sustain risk reduction was 34% in the lifestyle arm compared to placebo even though weights were no longer different between groups.”
From The Vasculature in Prediabetes (2018) · cites this paper as [18]
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“Positive treatment effects were observed for up to 10 years.(21) Weight loss was the dominant predictor of reduced diabetes risk.”
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“Additionally, metformin users also show a tendency toward sustained weight loss which is a potential benefit in obesity (Knowler et al., 2009).”
BackgroundDIA-DB: A Database and Web Server for the Prediction of Diabetes Drugs
Pérez‐Sánchez, H., den-Haan, H., Peña-García, J. J., Lozano‐Sánchez, J., Moreno, M. E. M., Sánchez-Pérez, A., Muñoz, A., Ruiz-Espinosa, P., Pereira, A. S. P., Katsikoudi, A., et al. (2020) · Journal of Chemical Information and Modeling · doi:10.1021/acs.jcim.0c00107 · Cited by 25
Reducing the Risk of Developing Diabetes
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“In light of the growing body of evidence demonstrating the benefits of physical activity, including decreasing both obesity-associated morbidity and mortality [29–30] and disability from chronic musculoskeletal pain [31], OIF/OEF veterans using the VA are an ideal population for interventions centered around increasin…”
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“The highly successful Diabetes Prevention Program (DPP), tested in a rigorous efficacy trial, convincingly demonstrated that an intensive lifestyle intervention led to sustained, clinically significant weight loss and reduced the risk for incident type 2 diabetes mellitus (diabetes) by 58% among high-risk adults [2–5].”
BackgroundA Home-Visiting Diabetes Prevention and Management Program for American Indian Youth
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“However, many of the prediabetic participants continue to march toward diabetes, albeit at a slower pace [9], and deploying a successful lifestyle intervention across the entire population at risk (~52 million in North America) is a massive undertaking.”
BackgroundDrivers of weight loss in a CDC-recognized digital diabetes prevention program
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“This notion was also supported by results from the Diabetes Prevention Program, which suggested that even a one-time weight loss intervention could have lasting effects on reducing T2D risk for at least 10 years [37].”
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Genetic Subtypes of Prediabetes, Healthy Lifestyle, and Risk of Type 2 Diabetes
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“Our intervention sites have begun to provide post intervention group booster sessions, similar to what the DPP provided to participants post-program [8].”
BackgroundInfluentialSalopuro, T., Saaristo, T., Oksa, H. H., Puolijoki, H., Vanhala, M. J., Ebeling, T., NISKANEN, L. K., Tuomilehto, J. O., Uusitupa, M. I. J., & Peltonen, M. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-350 · Cited by 22
Carlos, S., de Irala, J., Hanley, M., & Martínez‐González, M. Á. (2014) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2014-203884 · Cited by 27
Duijzer, G., Haveman‐Nies, A., Jansen, S. C., ter Beek, J., Hiddink, G. J., & Feskens, E. J. M. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-602 · Cited by 23
Reducing the Risk of Obesity: Defining the Role of Weight Loss Drugs
Ling, H., Lenz, T. L., Burns, T. L., & Hilleman, D. E. (2013) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.1277 · Cited by 21
Kolb, J. M., Kitos, N. R., Ramachandran, A., Lin, J. J., & Mann, D. M. (2014) · Journal of Bioinformatics and Diabetes · doi:10.14302/issn.2374-9431.jbd-13-312 · Cited by 21
Jagannathan, R., Ziolkowski, S., Weber, M. B., Cobb, J., Pham, N. M., Long, J., Anand, S., & Lobelo, F. (2018) · BMC Nephrology · doi:10.1186/s12882-018-1032-0 · Cited by 25
Lim, S., Wyatt, L. C., Chauhan, H., Zanowiak, J. M., Kavathe, R., Singh, H., Kwon, S. C., Trinh‐Shevrin, C., & Islam, N. S. (2019) · Health Behavior Research · doi:10.4148/2572-1836.1027 · Cited by 22
“Similar to the DPP, implementation of studies with a longer follow-up period assessing incidence of diabetes or sustained weight loss would also be scientifically valuable (Diabetes Prevention Program Research Group et al., 2009).”
Type 2 Diabetes Mellitus in Childhood and Adolescence
Koren, D., & Levitsky, L. L. (2021) · Pediatrics in Review · doi:10.1542/pir.2019-0236 · Cited by 25
What Is the Future of Stroke Prevention?
Kernan, W. N., Launer, L. J., & Goldstein, L. B. (2010) · Stroke · doi:10.1161/strokeaha.110.592022 · Cited by 22
Memish, Z. A., Chang, J., Saeedi, M. Y., Hamid, M., Abid, O., & Ali, M. K. (2015) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2014.0267 · Cited by 21
“13–15 Although the imperative is to identify people with prediabetes or type 2 diabetes as soon as possible to begin interventions, current diagnostic tests for type 2 diabetes—fasting plasma glucose (FPG) or oral glucose tolerance tests—are expensive and inconvenient to be administered…”
Current and Emerging Pharmacotherapies for Weight Management in Prediabetes and Diabetes
Lau, D. C. W., & Teoh, H. (2015) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2015.10.001 · Cited by 22
“9 kg) placebo-subtracted weight loss and a 18% relative risk reduction in the development of, or a 2-year delay in the onset of, type 2 diabetes (19,27) (Table 1).”
BackgroundYalamanchi, S., Stewart, K. J., Ji, N., Golden, S. H., Dobs, A. S., Becker, D. M., Vaidya, D. M., Kral, B. G., & Kalyani, R. R. (2016) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2016.09.026 · Cited by 21
Kitzman, H. E., Mamun, A. A., Dodgen, L., Slater, D., King, G., King, A., Slater, J. L., & DeHaven, M. J. (2020) · American Journal of Health Promotion · doi:10.1177/0890117120958545 · Cited by 21
“As shown in the Diabetes Prevention Program (DPP), improving diet, increasing physical activity, and modest weight reduction substantially improves chronic disease risk.(4) However, African American women tend to have less success than others in lifestyle interventions,(5-9) and to date, DPP translations in African Am…”
BackgroundMethodAng, I. Y. H., Tan, X. Q., Tan, C. M., Tan, C. H., Kwek, J. W. M., Tay, J., & Toh, S.-A. E. S. (2021) · JMIR Diabetes · doi:10.2196/25820 · Cited by 20
Changes in household diet: Determinants and predictability
Hut, S., & Oster, E. F. (2022) · Journal of Public Economics · doi:10.1016/j.jpubeco.2022.104620 · Cited by 21
Non-drug interventions of traditional Chinese medicine in preventing type 2 diabetes: a review
Liu, J., Yao, C., Wang, Y., Zhao, J., & Luo, H. (2023) · Chinese Medicine · doi:10.1186/s13020-023-00854-1 · Cited by 23
“This lifestyle or metformin prevention of diabetes can remain for at least a decade [45].”
BackgroundDixon, S. B., Wang, F., Lu, L., Wilson, C. L., Green, D. M., Merchant, T. E., Srivastava, D. K., Delaney, A., Howell, R. M., Jefferies, J. L., et al. (2023) · Journal of Clinical Oncology · doi:10.1200/jco.23.01005 · Cited by 21
Another Agent for Obesity — Will This Time Be Different?
Siraj, E. S., & Williams, K. J. (2015) · New England Journal of Medicine · doi:10.1056/nejme1506236 · Cited by 21
Metadata
- Authors
- Diabetes Prevention Program Research Group
- Corresponding author
- Diabetes Prevention Program Research Group
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 374
- Issue
- 9702
- Pages
- 1677-1686
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3135022
- OpenAlex
- W1511593276
- Cited by
- 3,020
- References
- 29
- Citations by year
- 2026: 95 · 2025: 112 · 2024: 159 · 2023: 183 · 2022: 179 · 2021: 190 · 2020: 196 · 2019: 166 · 2018: 201 · 2017: 225 · 2016: 230 · 2015: 228 · 2014: 217 · 2013: 188 · 2012: 190
- FWCI
- 108.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Diabetes Association
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048406, U01DK048489)
- National Institute of Child Health and Human Development
- National Center for Research Resources
- Office of Women's Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetes prevention, type 2 diabetes incidence, intensive lifestyle intervention, metformin, weight loss maintenance, weight regain, long-term follow-up, high-risk adults, Diabetes Prevention Program Outcomes Study, prediabetes, remission maintenance
- MeSH terms
- Aged, Analysis of Variance, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Double-Blind Method, Exercise Therapy, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Life Style, Male, Metformin, Middle Aged, Patient Education as Topic, Pregnancy, Regression Analysis, United States, Weight Loss, Incidence, Diabetes, Gestational, Treatment Outcome, Statistics, Nonparametric, Risk Reduction Behavior, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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