The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index; none of the 31 sources its claims cite is checked for support yet.
]. The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes
Open accessAbstract
BACKGROUND: The incidence of type 2 diabetes increases with age. It is unknown whether interventions to prevent diabetes are as effective in elderly persons as in younger adults. METHODS: The Diabetes Prevention Program (DPP) demonstrated that an intensive lifestyle intervention (ILS) or metformin could prevent or delay diabetes. A predefined secondary outcome of DPP was to determine if treatment effects varied by age. RESULTS: At baseline, participants aged 60-85 years were leaner and had the best insulin sensitivity and lowest insulin secretion compared to younger age groups. Diabetes incidence rates did not differ by age in the placebo group, but ILS was more effective with increasing age (6.3, 4.9, and 3.3 cases per 100 person-years, in the 25-44, 45-59, and 60-85 year age groups, respectively; p(trend) =.007). Participants aged 60-85 years had the most weight loss and metabolic equivalent (MET)-hours of physical activity. The metformin group showed a trend toward higher diabetes incidence among older participants (6.7, 7.7, and 9.3 cases per 100 person-years in the 25-44, 45-59, and 60-85 year age groups, respectively; p(trend) =.07); and diabetes risk increased with age (hazard ratio [age 60-85 vs 25-44] 1.63, p =.02), after adjusting for the greater weight loss in the 60-85 year age group. CONCLUSIONS: Lifestyle modification was exceptionally effective in preventing diabetes in older individuals; this finding was largely explained by greater weight loss and physical activity. The limited effectiveness of metformin in older persons may reflect age-related differences in insulin action and secretion. A lifestyle modification program can be recommended for older individuals at high risk for type 2 diabetes.
Overview
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Written from the paper’s full text.
TL;DR
In the Diabetes Prevention Program, intensive lifestyle intervention (ILS) prevented diabetes more effectively with increasing age, while metformin showed a borderline trend toward reduced effectiveness in older participants. The age-related ILS advantage was largely explained by greater weight loss and physical activity in the 60–85 year group.
Key findings
- Diabetes incidence in the placebo group did not differ by age (11.0, 10.8, and 10.3 cases per 100 person-years in the 25–44, 45–59, and 60–85 year groups; p = .71).
- ILS became more effective with increasing age: 6.3, 4.9, and 3.3 cases per 100 person-years in the 25–44, 45–59, and 60–85 year groups, respectively (p trend = .007). The 60–85 vs 25–44 hazard ratio was 0.47 (95% CI, 0.28–0.78) in Model 1, but the age difference disappeared after adjusting for time-dependent weight, calorie intake, and activity (HR, 0.83; 95% CI, 0.46–1.50).
- Metformin showed a borderline trend toward higher diabetes incidence with age: 6.7, 7.7, and 9.3 cases per 100 person-years in the 25–44, 45–59, and 60–85 year groups (p trend = .07). In Table 4, the 60–85 vs 25–44 hazard ratio was 1.45 (95% CI, 0.98–2.16) in Model 1 and 1.37 (95% CI, 0.87–2.16) in Model 3.
- Older participants had the most weight loss and physical activity: mean weight change was −6.4 kg in the 60–85 group vs −4.1 kg and −5.0 kg in the younger groups; recreational activity change was 18.7 MET-h/wk vs 4.4 and 5.8 MET-h/wk; 55% vs 33% and 39% reached the 7% weight-loss goal, and 48% vs 34% and 38% reached the 150 min/wk exercise goal.
Methods
- This was a predefined secondary analysis of the Diabetes Prevention Program, a multicenter randomized controlled trial. Participants were aged ≥25 years with impaired glucose tolerance and fasting plasma glucose 95–125 mg/dL; they were randomized to ILS, metformin 850 mg twice daily, or placebo, and followed for an average of 3.2 years.
- For this analysis, participants were divided into three age groups: 25–44, 45–59, and 60–85 years. Diabetes was determined by annual oral glucose tolerance testing and semiannual fasting plasma glucose, with confirmation by a second test.
- Analyses used Kruskal-Wallis tests for baseline characteristics, mixed-effects models for continuous changes, generalized estimating equations for goal attainment, and Cox proportional hazards models for time to diabetes, with linear trend tests and step-down Bonferroni adjustment for pairwise comparisons.
Limitations
- The paper states that ethnic and sex distributions were unequal across age groups, with men and Caucasians over-represented among older participants; the study had limited power to detect age differences in this predefined secondary outcome; and the DPP cohort was relatively healthy and motivated, excluding individuals with significant physical limitations, so results may not apply to frail or disabled elderly persons.
- The paper also states that the numbers precluded meaningful stratified analyses to examine the effect of unequal ethnic and sex distributions in some age groups.
- The text makes evident that age-group comparisons are nonrandomized even though treatment assignment was randomized, so residual confounding by age-related factors cannot be excluded.
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Claims the paper makes
48 Own result · 22 Not checked yet · 22 Own interpretation · 13 Own method · 2 No basis given
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 contrast, there were no significant changes in weight or waist circumference at any age in the placebo group.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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 baseline, participants aged 60-85 years were leaner and had the best insulin sensitivity and lowest insulin secretion compared to younger age groups.”
- Also stated in: § RESULTS · plain
“The 60-85 year age group also had the lowest baseline waist circumference, weight, body mass index, insulin secretion, and insulin resistance.”
- Also stated in: § DISCUSSION · plain
“The three age groups were generally well matched at baseline for glucose parameters, but the older group was significantly more insulin-sensitive and had greater impairment of insulin secretion than the young or middle-aged groups.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Abstract
plaincorrelational- 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.
- 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
“In contrast, there were no significant changes in weight or waist circumference at any age in the placebo group.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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
“Although ILS was effective in all age groups, diabetes incidence rates fell with increasing age”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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.
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
“Weight loss, reduction in waist circumference, and percentage of participants who achieved the 7% weight loss goal all increased with increasing age.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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.
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
“Weight loss, reduction in waist circumference, and percentage of participants who achieved the 7% weight loss goal all increased with increasing age.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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.
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
“There were no differences in reduction of reported caloric intake or in the percent reverting to normal glucose tolerance among the age groups.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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 did not differ by age in the placebo group, but ILS was more effective with increasing age”
- Also stated in: § RESULTS · plain
“Diabetes incidence did not differ by age in the placebo group (11.0, 10.8, and 10.3 cases per 100 person-years in young, middle-aged, and older groups, respectively; p ¼ .71).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Abstract
plainn = 100- 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.
- 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
“There were no differences in reduction of reported caloric intake or in the percent reverting to normal glucose tolerance among the age groups.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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
“Older participants also reported greater MET-h/wk of recreational activity and were more likely to achieve the exercise goal of 150 min/wk.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
plaincorrelational- 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. 22
- Probably not a substantial claim. 26
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
“Likewise, waist circumference was reduced, with the greatest change in the 60-85 year age group.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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 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 both the metformin and placebo groups, there was a trend toward increased medication adherence and increased recreational activity with age.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
hedgedcorrelational- 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.
In the paper
“As has been previously observed with this drug (21), the metformin participants experienced modest weight loss, which was greatest in the oldest age group.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
What the sources say
- Not checked yetcites [21] 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 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 pattern of diabetes conversion was most apparent in the metformin group, although differences by treatment group were not statistically significant.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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 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 mean ages of the young and middle-aged groups were 38.8 and 51.6 years, respectively.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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.
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
“Most DPP ILS participants achieved their exercise goal through low-level aerobic activity, such as brisk walking or cycling, with a small contribution from resistance training.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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
“Compared to young and middle-aged participants, older participants were more likely to be male (21% vs 31% vs 49%, p , .0001) and Caucasian (47% vs 55% vs 66%, p , .0001).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
plaincorrelational- 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 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
“Twenty percent of participants were 60 years old or older at the beginning of the study, with a mean age of 66.4 years.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
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 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
“Compared to young and middle-aged participants, older participants were more likely to be male (21% vs 31% vs 49%, p , .0001) and Caucasian (47% vs 55% vs 66%, p , .0001).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > RESULTS
plaincorrelational- 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 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
“Male ILS participants lost more weight and reported more exercise than did female ILS participants”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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 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
“Lifestyle | 60-85 vs 25-44 | 0.47 (0.28-0.78) | ,.01 | 0.50 (0.29-0.89) | .02 | 0.83 (0.46-1.50) | .54”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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 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
“Recreational activity change (MET-h/wk) | À0.9 (1.5) | 3.7 (1.4) | 12.8 (2.5) | ,.001 #, * ,y”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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 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
“Metformin | 60-85 vs 25-44 | 1.45 (0.98-2.16) | .06 | 1.26 (0.80-1.93) | .33 | 1.37 (0.87-2.16) | .17”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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 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
“Recreational activity change (MET-h/wk) | À3.0 (1.7) | À1.1 (1.2) | 15.6 (2.1) | ,.001* ,y”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaindirect- 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.
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
“although Caucasians and Hispanics lost more weight than African Americans did”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
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.
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
“Among metformin participants, diabetes risk reduction was similar in men and women (37% and 27%; p ¼ .41)and among ethnic groups”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
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.
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
“Among those persons who progressed to diabetes within DPP, we observed that younger participants were more likely to convert by fasting glucose criteria, and older participants by 2-hour criteria.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Development of diabetes was determined by an annual oral glucose tolerance test and semiannual fasting plasma glucose tests, and required confirmation by a second test, using the criteria of the American Diabetes Association and the World Health Organization (12,13).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Outcomes
What the sources say
- Not checked yetcites [12] source
- Not checked yetcites [13]
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. 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
“ILS goals and procedures were uniform across all age groups.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Design
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
“The prevention or delay of diabetes by metformin or lifestyle modification was the primary outcome in DPP, but a predefined secondary outcome was to determine whether treatment effects varied by age, sex, or race.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Abstract
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.
Probably not a substantial claim. 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
“This finding suggests that the older metformin group may have had a somewhat higher risk of diabetes at baseline, which could account for some of the observed difference in treatment effect.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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
“All participants provided written informed consent and signed documents approved by the Institutional Review Board at each center.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Design
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 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
“DPP data indicate that there are significant age differences in response to either lifestyle modification or metformin, which appear to reflect variation in both behavior and biology.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
hedgedcorrelational- 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
“Recruitment into the DPP was designed to represent varied ethnic and racial groups, both sexes, and both younger and older individuals to reflect the U.S. population at risk for diabetes.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Abstract
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
“The reasons for differences in ILS participation among the age groups were not formally assessed in DPP.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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 data would support anecdotal evidence that younger participants had family and work responsibilities that could interfere with lifestyle changes, whereas older participants had fewer competing obligations and more time to devote to the ILS program.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
hedgedconditional- 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 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, this pattern was not observed in the placebo or lifestyle groups, suggesting that metformin effectiveness is tied to metabolic profile, being most effective in insulin-resistant individuals and less so in those individuals whose predominant metabolic defect is impaired insulin secretion.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
hedgedcorrelational- 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
“To correct for some imbalance among the three age groups at baseline, the above models were adjusted for baseline values when applicable.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Data Analysis
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.
None of the sources cited for this claim have been checked yet.
In the paper
“Other studies have also demonstrated that diabetes can be prevented (or delayed) by lifestyle change (23,24) and medication (25,26), but the DPP provides unique information about prevention in older adults.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
What the sources say
boosteddirect- 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.
In the paper
“Values of p for pair-wise comparison between any two age groups were adjusted for multiple comparisons by using the step-down Bonferroni method (20).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Data Analysis
What the sources say
- Not checked yetcites [20] source
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
“Timedependent proportional hazards analyses were performed to adjust for weight change and physical activity change during the study.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Data Analysis
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.
In the paper
“The amount of physical activity was assessed using two standardized and validated questionnaires, the Low-level Physical Activity Recall (LoPAR) and the Modified Activity Questionnaire (MAQ), which were completed annually (14).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Outcomes
What the sources say
- Not checked yetcites [14] source
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
“Medication adherence was determined by pill count at each quarterly visit.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Outcomes
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.
In the paper
“Improvements in insulin action and reduction in hyperinsulinemia have also been reported in older, nondiabetic men following shortterm strength training (35).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
What the sources say
- Not checked yetcites [35] source
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.
In the paper
“Age-related deterioration in glucose tolerance reflects both impaired insulin secretion and declining insulin sensitivity (27)(28)(29).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
What the sources say
- Not checked yetcites (27)(28)(29)
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.
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 DPP ILS program was not designed to determine the individual effectiveness of diet change versus exercise or to determine the most effective form of exercise.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
In the paper
“The primary mechanism for the antidiabetic effect of metformin is through suppression of hepatic glucose production, which is the major determinant of fasting plasma glucose levels but plays a more minor role in postchallenge (or postprandial) hyperglycemia (21).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
What the sources say
- Not checked yetcites [21] 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.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Dietary intake was assessed at baseline and year 1 by using a modified version of the Block Food Frequency Questionnaire (15).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Outcomes
What the sources say
- Not checked yetcites [15] source
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.
In the paper
“Diet-induced weight loss improves insulin sensitivity and insulin secretion in older patients (30), but data are conflicting about whether exercise can enhance insulin action and improve glucose tolerance, independent of weight loss (31).”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
What the sources say
- Not checked yetcites [30] 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.
- 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
“Although age differences in response to intervention was a predetermined secondary outcome in DPP”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > 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.
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
“Ethnic and sex distributions were not equal in all age groups, with men and Caucasians over-represented among older participants.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
plaincorrelational- 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.
The authors state this as an assumption.
It is unknown whether interventions to prevent diabetes are as effective in elderly persons as in younger adults.
“It is unknown whether interventions to prevent diabetes are as effective in elderly persons as in younger adults.”
The paper relies on this without support.
The incidence of type 2 diabetes increases with age.
“The incidence of type 2 diabetes increases with age.”
The paper relies on this without support.
The metabolic defects underlying the development of diabetes and the ability to adhere to lifestyle modification may vary by age and could influence the effectiveness of diabetes prevention in older individuals.
“The metabolic defects underlying the development of diabetes and the ability to adhere to lifestyle modification may vary by age and could influence the effectiveness of diabetes prevention in older individuals.”
The paper relies on this without support.
The DPP cohort was a relatively healthy and motivated group.
“As noted, the DPP cohort was a relatively healthy and motivated group”
The paper relies on this without support.
The DPP ILS program was well-tolerated by older participants.
“On the whole, the DPP ILS program of low-intensity aerobic activity and low-fat, reduced-calorie diet was well-tolerated by older participants”
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 cited source says what the claim attributes to it.
In the citing paper
“These participants seemed to have more efficacy from the lifestyle intervention than younger participants, but did not appear to benefit from metformin13, 18.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [18]
In the citing paper
“the use of metformin may negate some of the positive effects of exercise and lifestyle and less favorable effects in older subjects as was also emphasized by the Diabetes Prevention Program (265, 266).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [265]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > Data Analysis
“For these analyses, participants were divided into 3 age groups: 25-44 years, 44-59 years, and 60-85 years, representing young, middle-aged, and older age individuals.”
§ The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes The Diabetes Prevention Program Research Group* [Prepared by > DISCUSSION
“| Treatment Group | Measures | 25-44 Years | 45-59 Years | 60-85 Years | p Value* |”
Citations
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“Other studies have also demonstrated that diabetes can be prevented (or delayed) by lifestyle change (23,24) and medication (25,26), but the DPP provides unique information about prevention in older adults.”
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Cited by
Sorted by citations
Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., Nadolsky, K., Pessah-Pollack, R., & Plodkowski, R. (2016) · Endocrine Practice · doi:10.4158/ep161365.gl · Cited by 1,914
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Type 2 diabetes mellitus in older adults: clinical considerations and management
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Diabetes in Older Adults: A Consensus Report
Sue Kirkman, M., Briscoe, V. J., Clark, N., Florez, H., Haas, L. B., Halter, J. B., Huang, E. S., Korytkowski, M. T., Munshi, M. N., Odegard, P. S., et al. (2012) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12035 · Cited by 548
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Exercise Promotes Healthy Aging of Skeletal Muscle
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“…with a high risk for developing type 2 diabetes, the oldest group (60–85 years old) exceeded the younger group in achieving both the 7% weight loss and 150 min/week physical activity goals, and the oldest group was most successful in preventing diabetes (Crandall et al., 2006;Wing et al., 2004).”
BackgroundAge-related changes in glucose metabolism, hyperglycemia, and cardiovascular risk
Chia, C. W., Egan, J. M., & Ferrucci, L. (2018) · Circulation Research · doi:10.1161/circresaha.118.312806 · Cited by 454
“This concept has already been eloquently studied in the Diabetes Prevention Program, which showed that diet and exercise were more effective than metformin in preventing development of diabetes mellitus.(206)”
BackgroundChung, W. K., Erion, K., Florez, J. C., Hattersley, A. T., Hivert, M.-F., Lee, C. G., McCarthy, M. I., Nolan, J. J., Norris, J. M., Pearson, E. R., et al. (2020) · Diabetes Care · doi:10.2337/dci20-0022 · Cited by 400
LeBlanc, E. S., O’Connor, E., Whitlock, E. P., Patnode, C. D., & Kapka, T. J. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-7-201110040-00006 · Cited by 409
“Gastrointestinal symptoms were the main reason for excess adverse effects (22, 83, 86, 102).”
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Obesity and weight management in the elderly
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Exercise or exercise and diet for preventing type 2 diabetes mellitus
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Hemmingsen, B., Gimenez-Perez, G., Mauricio, D., Roqué i Figuls, M., Metzendorf, M.-I., & Richter, B. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003054.pub4 · Cited by 316
Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis
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Pilot study of resveratrol in older adults with impaired glucose tolerance
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The Lifestyle Interventions and Independence for Elders Study: Design and Methods
Fielding, R. A., Rejeski, W. J., Blair, S. N., Church, T. S., Espeland, M. A., Gill, T. M., Guralnik, J. M., Hsu, F.-C., Katula, J. A., King, A. C., et al. (2011) · The Journals of Gerontology Series A · doi:10.1093/gerona/glr123 · Cited by 288
“Recently, an age-stratified analysis of the results of the Diabetes Prevention Program revealed that adherence to the PA component of the intensive lifestyle intervention (≥150 min/wk of PA) was achieved in 48% of participants 60–85 years compared with 38% and 34% in 45- to 59-year-olds and 25- to 44-year-olds, respec…”
ResultMohammed, I., Hollenberg, M. D., Ding, H., & Triggle, C. R. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.718942 · Cited by 278
The prevention of type 2 diabetes
F. T. D. P. P. R. G., Crandall, J. P., Knowler, W. C., Kahn, S. E., Marrero, D., Florez, J. C., Bray, G. A., Haffner, S. M., Hoskin, M., & Nathan, D. M. (2008) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0843 · Cited by 261
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Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease
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Management of the Metabolic Syndrome and Type 2 Diabetes Through Lifestyle Modification
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“Older subjects exhibited greater benefit from lifestyle modification than did younger subjects, the difference being largely explained by greater amounts of weight loss among the former (44).”
BackgroundMathus-Vliegen, E. M. H., Basdevant, A., Finer, N., Hainer, V., Hauner, H., Micic, D., Maislos, M., Roman, G., Schutz, Y., Tsigos, C., et al. (2012) · Obesity Facts · doi:10.1159/000341193 · Cited by 261
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Glechner, A., Keuchel, L., Affengruber, L., Titscher, V., Sommer, I., Matyas, N., Wagner, G., Kien, C., Klerings, I., & Gartlehner, G. (2018) · Primary care diabetes · doi:10.1016/j.pcd.2018.07.003 · Cited by 226
Regression from pre-diabetes to normal glucose regulation in the diabetes prevention program
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“This was seen despite the previous finding that older DPP participants had greater success meeting ILS goals and with it the beneficial effect of lower diabetes incidence (18).”
ResultThe Pathophysiology of Hyperglycemia in Older Adults: Clinical Considerations
Lee, P., & Halter, J. B. (2017) · Diabetes Care · doi:10.2337/dc16-1732 · Cited by 226
Chung, W. K., Erion, K., Florez, J. C., Hattersley, A. T., Hivert, M.-F., Lee, C. G., McCarthy, M. I., Nolan, J. J., Norris, J. M., Pearson, E. R., et al. (2020) · Diabetologia · doi:10.1007/s00125-020-05181-w · Cited by 203
“Although the reductions in diabetes risk from lifestyle (58% reduction) and metformin (31% reduction) compared with the control intervention were impressive [70], there was considerable variation across the study population [71], with many participants developing type 2 diabetes during the active intervention period (…”
Weighty Concerns: The Growing Prevalence of Obesity among Older Adults
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Diabetes and Aging: Epidemiologic Overview
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Lindström, J., Peltonen, M., Eriksson, J. G., Aunola, S., Hämäläinen, H., Ilanne‐Parikka, P., Keinanen-Kiukaanniemi, S. M., Uusitupa, M. I. J., Tuomilehto, J. O., & for the Finnish Diabetes Prevention Study (DPS) Group (2008) · Diabetes Care · doi:10.2337/dc07-2162 · Cited by 163
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“In the Diabetes Prevention Program, structured advice on activity and diet was more effective for reducing the risk of developing type 2 diabetes in the older participants (60–85 years) than in the younger participants (25–44 and 45–59 years) [6].”
BackgroundAdiponectin, Change in Adiponectin, and Progression to Diabetes in the Diabetes Prevention Program
Mather, K. J., Funahashi, T., Matsuzawa, Y., Edelstein, S. L., Bray, G. A., Kahn, S. E., Crandall, J. P., Marcovina, S. M., Goldstein, B., Goldberg, R. B., et al. (2008) · Diabetes · doi:10.2337/db07-1419 · Cited by 161
“Changes over this first year interval have since proven to relate strongly to progression to diabetes (25-28).”
BackgroundAging, Diabetes, and the Public Health System in the United States
Caspersen, C. J., Thomas, G. D., Boseman, L. A., Beckles, G. L., & Albright, A. L. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300616 · Cited by 162
Barzilay, J. I., Cotsonis, G. A., Walston, J., Schwartz, A. V., Satterfield, S., Miljkovic, I., Harris, T. B., & Study, F. T. H. A. (2009) · Diabetes Care · doi:10.2337/dc08-1781 · Cited by 144
Metformin and ageing: improving ageing outcomes beyond glycaemic control
Valencia, W. M., Palacio, A., Tamariz, L., & Florez, H. (2017) · Diabetologia · doi:10.1007/s00125-017-4349-5 · Cited by 142
“In the Diabetes Prevention Program (DPP), the efficacy of metformin in those aged 60 or older was not evident in the initial phase (using fasting and 2-h postchallenge glucose criteria) [8].”
Gillett, M., Royle, P., Snaith, A., Scotland, G., Poobalan, A. S., Imamura, M., Black, C., Boroujerdi, M. A., Jick, S. S., Wyness, L., et al. (2012) · Health Technology Assessment · doi:10.3310/hta16330 · Cited by 150
Dietary Weight Loss and Exercise Effects on Insulin Resistance in Postmenopausal Women
Mason, C. E., Foster‐Schubert, K. E., Imayama, I., Kong, A., Xiao, L., Bain, C. E., Campbell, K. L., Wang, C.-Y., Duggan, C. R., Ulrich, C. M., et al. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.06.042 · Cited by 146
Witham, M. D., & Avenell, A. (2010) · Age and Ageing · doi:10.1093/ageing/afp251 · Cited by 141
Diabetes Prevention Program Research Group (2015) · Diabetes Care · doi:10.2337/dc14-0886 · Cited by 139
Baptista, T., Rangel, N., Fernández, V., Carrizo, E., Fakih, Y. E., Uzcátegui, E., Galeazzi, T., Gutiérrez, M. A. M., Servigna, M., Dávila, A., et al. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.03.029 · Cited by 138
Metformin Pharmacogenomics: Current Status and Future Directions
Pawlyk, A. C., Giacomini, K. M., McKeon, C., Shuldiner, A. R., & Florez, J. C. (2014) · Diabetes · doi:10.2337/db13-1367 · Cited by 135
“Variability in the ability of metformin to prevent diabetes was seen, with it being less effective in the older participants (35) but more effective in the more obese participants (36).”
BackgroundIncidence of Remission in Adults With Type 2 Diabetes: The Diabetes & Aging Study
Karter, A. J., Nundy, S., Parker, M. M., Moffet, H. H., & Huang, E. S. (2014) · Diabetes Care · doi:10.2337/dc14-0874 · Cited by 132
“est risk reduction in diabetes from lifestyle modification (29,30), findings that have particular salience given that the prevalence of type 2 diabetes is highest among the elderly (25).”
BackgroundCastro Sweet, C. M., Chiguluri, V., Gumpina, R., Abbott, P., Madero, E. N., Payne, M., Happe, L., Matanich, R., Renda, A., & Prewitt, T. (2018) · Journal of Aging and Health · doi:10.1177/0898264316688791 · Cited by 130
“Given the successes that older adults have had with in-person DPP and the increasing uptake of Internet and computer use among this age group (Pew Research Center, 2014), Internet-based delivery of intensive behavioral counseling has the potential to be effective with this particular segment of the population.”
BackgroundResultInfluentialEffects of a Renal Rehabilitation Exercise Program in Patients with CKD
Rossi, A., Burris, D., Lucas, F. L., Crocker, G. A., & Wasserman, J. C. (2014) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.11791113 · Cited by 122
Meneilly, G. S., Knip, A., Miller, D. B., Sherifali, D., Tessier, D., & Zahedi, A. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.021 · Cited by 120
Finucane, F. M., Sharp, S. J., Purslow, L. R., Horton, K., Horton, J., Savage, D., Brage, S., Besson, H., Rolfe, E. D. L., Sleigh, A., et al. (2010) · Diabetologia · doi:10.1007/s00125-009-1641-z · Cited by 120
“In the diabetes prevention trials, older participants derived more benefit from lifestyle interventions than younger ones [5, 10].”
Horton, E. S. (2009) · Obesity · doi:10.1038/oby.2009.388 · Cited by 111
Hanefeld, M. (2007) · Cardiovascular Diabetology · doi:10.1186/1475-2840-6-20 · Cited by 108
Diabetes in ageing: pathways for developing the evidence base for clinical guidance
Munshi, M. N., Meneilly, G. S., Rodríguez‐Mañas, L., Close, K. L., Conlin, P. R., Cukierman‐Yaffe, T., Forbes, A., Ganda, O. P., Kahn, C. R., Huang, E. S., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30230-8 · Cited by 107
Diabetes mellitus and gait dysfunction: possible explanatory factors
Brach, J. S., Talkowski, J. B., Strotmeyer, E. S., & Newman, A. B. (2008) · Physical Therapy · doi:10.2522/ptj.20080016 · Cited by 101
Mortality Implications of Prediabetes and Diabetes in Older Adults
Tang, O., Matsushita, K., Coresh, J., Sharrett, A. R., McEvoy, J. W., Windham, B. G., Ballantyne, C. M., & Selvin, E. (2019) · Diabetes Care · doi:10.2337/dc19-1221 · Cited by 93
“Prior work in the Diabetes Prevention Program supports the efficacy of intensive lifestyle modification, consisting of physical activity and weight loss, in older adults (37).”
MethodHayden, M. R. (2019) · Brain Sciences · doi:10.3390/brainsci9100262 · Cited by 95
Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults
Sahyoun, N. R., Anderson, A. L., Tylavsky, F. A., Lee, J. S., Sellmeyer, D. E., & Harris, T. B. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.1.126 · Cited by 89
Patterns of success: Online self-monitoring in a web-based behavioral weight control program.
Krukowski, R. A., Harvey‐Berino, J., Bursac, Z., Ashikaga, T., & West, D. S. (2012) · Health Psychology · doi:10.1037/a0028135 · Cited by 90
Solymár, M., Ivić, I. D., Pótó, L., Hegyi, P. J., Garami, A., Hartmann, P., Pétervári, E., Czopf, L., Hussain, A., Gyöngyi, Z., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0207947 · Cited by 86
Type 2 Diabetes Prevention: A Review
Ahmad, L. A., & Crandall, J. P. (2010) · Clinical Diabetes · doi:10.2337/diaclin.28.2.53 · Cited by 86
Moin, T., Li, J., Duru, O. K., Ettner, S., Turk, N., Keckhafer, A., Ho, S., & Mangione, C. M. (2015) · Annals of Internal Medicine · doi:10.7326/m14-1773 · Cited by 90
Activity Adherence and Physical Function in Older Adults with Functional Limitations
Fielding, R. A., Katula, J. A., Miller, M. E., ABBOTT-PILLOLA, K., JORDAN, A. N., Glynn, N. W., GOODPASTER, B., Walkup, M. P., King, A. C., & Rejeski, W. J. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318145348d · Cited by 86
“An age-stratified analysis of the results of the DPP reveals that adherence to the physical activity component of the intensive lifestyle intervention (Q 150 minIwk of physical activity) was achieved in 48% of participants 60–85 yr, compared with 38% in 45- to 59-yr-olds and 34% in 25- to 44-yr-olds, during the approx…”
MethodMeneilly, G. S., Knip, A., & Tessier, D. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.01.045 · Cited by 83
Al-Mhanna, S. B., Rocha‐Rodrigues, S., Mohamed, M., Batrakoulis, A., Aldhahi, M. I., Afolabi, H. A., Yağın, F. H., Alhussain, M. H., Gülü, M., Abubakar, B. D., et al. (2023) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-023-00766-5 · Cited by 88
Translating the Science of Aging into Therapeutic Interventions
Kirkland, J. L. (2016) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a025908 · Cited by 78
“Several of these agents also appear to delay cancers, cognitive decline, cardiac dysfunction, and other agerelated diseases and disabilities in several species, including humans (Chiasson et al. 2002; Zeymer et al. 2004; Basso et al. 2005; Dykens et al. 2005; Johnson et al. 2005; Crandall et al. 2006; Hanon et al. 200…”
BackgroundMordarska, K., & Godziejewska-Zawada, M. (2017) · Menopause Review/Przegląd Menopauzalny · doi:10.5114/pm.2017.68589 · Cited by 75
Review of Metformin Use for Type 2 Diabetes Prevention
Moin, T., Schmittdiel, J. A., Flory, J. H., Yeh, J., Karter, A. J., Kruge, L. E., Schillinger, D., Mangione, C. M., Herman, W. H., & Walker, E. A. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.04.038 · Cited by 75
Lifestyle Intervention Strategy to Treat Diabetes in Older Adults: A Randomized Controlled Trial
Celli, A., Barnouin, Y., Jiang, B. C., Blevins, D., Colleluori, G., Mediwala, S. N., Armamento‐Villareal, R., Qualls, C., & Villareal, D. T. (2022) · Diabetes Care · doi:10.2337/dc22-0338 · Cited by 81
Madsen, K. S., Chi, Y., Metzendorf, M.-I., Richter, B., & Hemmingsen, B. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008558.pub2 · Cited by 70
Perreault, L., & Færch, K. (2013) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2013.10.008 · Cited by 82
“2008) and the elderly (Crandall et al. 2006), commensurate with their higher 2-h plasma glucose concentrations (vs.”
BackgroundShea, M. K., Nicklas, B. J., Houston, D. K., Miller, M. E., Davis, C., Kitzman, D. W., Espeland, M. A., Appel, L. J., & Kritchevsky, S. B. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.006379 · Cited by 69
Menopause and risk of diabetes in the Diabetes Prevention Program
Kim, C., Edelstein, S. L., Crandall, J. P., Dabelea, D., Kitabchi, A. E., Hamman, R. F., Montez, M. G., Perreault, L., Foulkes, M. A., & Barrett-Connor, E. L. (2011) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e31820f62d0 · Cited by 68
Espeland, M. A., Rejeski, W. J., West, D. S., Bray, G. A., Clark, J. M., Peters, A. L., Chen, H., Johnson, K. C., Horton, E. S., Hazuda, H. P., et al. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12271 · Cited by 66
Bellettiere, J., Healy, G. N., LaMonte, M. J., Kerr, J., Evenson, K. R., Rillamas‐Sun, E., Di, C., Büchner, D. M., Hovell, M. F., & LaCroix, A. Z. (2018) · The Journals of Gerontology Series A · doi:10.1093/gerona/gly101 · Cited by 63
“Intensive lifestyle modification (ie, increased moderate intensity physical activity and weight loss) has proven effective at preventing type 2 diabetes in older adults (4).”
BackgroundMichaelides, A. P., Major, J., Pienkosz, E., Wood, M., Kim, Y., & Toro‐Ramos, T. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.9161 · Cited by 62
Mobile Diabetes Intervention for Glycemic Control in 45- to 64-Year-Old Persons With Type 2 Diabetes
Quinn, C. C., Shardell, M. D., Terrin, M. L., Barr, E. A., Park, D., Shaikh, F., Guralnik, J. M., & Gruber‐Baldini, A. L. (2014) · Journal of Applied Gerontology · doi:10.1177/0733464814542611 · Cited by 63
Hemmingsen, B., Sonne, D. P., Metzendorf, M., & Richter, B. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012151.pub2 · Cited by 76
Quinn, C. C., Butler, E. C., Swasey, K. K., Shardell, M. D., Terrin, M. L., Barr, E. A., & Gruber‐Baldini, A. L. (2018) · JMIR mhealth and uhealth · doi:10.2196/mhealth.9265 · Cited by 67
Calorie restriction in overweight older adults: Do benefits exceed potential risks?
Locher, J. L., Goldsby, T. U., Goss, A. M., Kilgore, M. L., Gower, B. A., & Ard, J. D. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.009 · Cited by 64
Older Adult Self-Efficacy Study of Mobile Phone Diabetes Management
Quinn, C. C., Khokhar, B., Weed, K., Barr, E. A., & Gruber‐Baldini, A. L. (2015) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2014.0341 · Cited by 61
Obesity and weight management in the elderly: A focus on men
Han, T. S., Wu, F. C. W., & Lean, M. E. J. (2013) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2013.04.012 · Cited by 57
Aging and physical function in type 2 diabetes: 8 years of an intensive lifestyle intervention
Rejeski, W. J., Bray, G. A., Chen, S.-H., Clark, J. M., Evans, M., Hill, J. O., Jakicic, J. M., Johnson, K. C., Neiberg, R., Ip, E. H., et al. (2015) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glu083 · Cited by 56
“Published results from both the Diabetes Prevention Program (14) and Look AHEAD (15) would suggest that older participants should derive more benefit in PF from the ILI treatment than younger participants.”
BackgroundResultEffects of a 2-Year Primary Care Lifestyle Intervention on Cardiometabolic Risk Factors
Höchsmann, C., Dorling, J. L., Martin, C. K., Newton, R. L., Apolzan, J. W., Myers, C. A., Denstel, K. D., Mire, E. F., Johnson, W. D., Zhang, D., et al. (2021) · Circulation · doi:10.1161/circulationaha.120.051328 · Cited by 59
Goode, R. W., Ye, L., Sereika, S. M., Zheng, Y., Mattos, M. K., Acharya, S. D., Ewing, L. J., Danford, C. A., Hu, L., Imes, C. C., et al. (2015) · Eating Behaviors · doi:10.1016/j.eatbeh.2015.11.009 · Cited by 60
Diabetes and Cardiovascular Disease Prevention in Older Adults
Cigolle, C. T., Blaum, C. S., & Halter, J. B. (2009) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2009.09.001 · Cited by 50
Jefferis, B. J. M. H., Whincup, P. H., LENNON, L. T., & Wannamethee, S. G. (2012) · Diabetes Care · doi:10.2337/dc11-2280 · Cited by 57
Sex-specific differences in diabetes prevention: a systematic review and meta-analysis
Glechner, A., Harreiter, J., Gartlehner, G., Rohleder, S., Kautzky, A., Tuomilehto, J. O., Noord, M. V., Kaminski-Hartenthaler, A., & Kautzky‐Willer, A. (2014) · Diabetologia · doi:10.1007/s00125-014-3439-x · Cited by 56
“Eighteen RCTs (44 articles) met our eligibility criteria [1, 2, 13–15, 19–57].”
BackgroundEffectiveness of weight loss interventions for obese older adults
Felix, H. C., & West, D. S. (2013) · American Journal of Health Promotion · doi:10.4278/ajhp.110617-lit-259 · Cited by 47
“1 kg), and a significantly higher percentage of older adults reached the weight loss goal of 7% of body weight by 1 year (60–85 years 5 55%, 45–59 years 5 239%, 25–44 years 5 33%).(42) As with most of the lifestyle interventions, the DPP lifestyle arm involved a reduced-calorie, low-fat diet coupled with moderate phys…”
BackgroundResultFonseca, V. A. (2007) · Clinical cornerstone · doi:10.1016/s1098-3597(07)80017-2 · Cited by 44
Thomas, C., Sadler, S., Breeze, P. R., Squires, H., Gillett, M., & Brennan, A. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-014953 · Cited by 44
Adiposis Dolorosa Is More Than Painful Fat
Herbst, K. L., & Asare-Bediako, S. (2007) · The Endocrinologist · doi:10.1097/ten.0b013e31815942294 · Cited by 42
Personal Care Assistance Needs of Obese Elders Entering Nursing Homes
Felix, H. C. (2008) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2008.01.011 · Cited by 40
Hoskin, M. A., Bray, G. A., Hattaway, K., Khare-Ranade, P., Pomeroy, J. J., Semler, L., Weinzierl, V., & Wylie‐Rosett, J. (2014) · Current Nutrition Reports · doi:10.1007/s13668-014-0094-2 · Cited by 42
Morey, M. C., Pieper, C. F., Edelman, D. E., Yancy, W. S., Green, J. B., Lum, H., Peterson, M. J., Sloane, R. J., Cowper, P. A., Bosworth, H. B., et al. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04119.x · Cited by 39
“The Diabetes Prevention Program (DPP) showed that an intervention advocating weight loss and physical activity reduced the development of diabetes mellitus approximately 71% in adults aged 60 and older.(2) Subsequent research has confirmed the independent benefit of physical activity in preventing diabetes mellitus af…”
BackgroundNew-Onset Diabetes in Elderly Subjects
Twito, O., Ahron, E., Jaffe, A., Afek, S., Cohen, E., Granek-Catarivas, M., Klein, P., & Hermoni, D. (2013) · Diabetes Care · doi:10.2337/dc12-2503 · Cited by 37
dos Santos, R. R., Bicalho, M. A. C., Mota, P., de Oliveira, D. R., & de Moraes, E. N. (2013) · Revista Médica de Minas Gerais · doi:10.5935/2238-3182.20130011 · Cited by 44
Taming expectations of metformin as a treatment to extend healthspan
Konopka, A. R., & Miller, B. F. (2019) · GeroScience · doi:10.1007/s11357-019-00057-3 · Cited by 42
Valencia, W. M., Stoutenberg, M., & Florez, H. (2014) · Current Diabetes Reports · doi:10.1007/s11892-014-0539-4 · Cited by 37
Metformin for Atypical Antipsychotic-Induced Weight Gain and Glucose Metabolism Dysregulation
Hasnain, M., Vieweg, W. V. R., & Fredrickson, S. K. (2010) · CNS Drugs · doi:10.2165/11530130-000000000-00000 · Cited by 35
Caloric Restriction for Treatment of Geriatric Obesity: Do the Benefits Outweigh the Risks?
Normandin, É., Houston, D. K., & Nicklas, B. J. (2015) · Current Nutrition Reports · doi:10.1007/s13668-015-0123-9 · Cited by 37
Uptake of the centers for medicare and medicaid obesity benefit: 2012–2013
Batsis, J. A., & Bynum, J. (2016) · Obesity · doi:10.1002/oby.21578 · Cited by 34
Sedentary Behavior and Diabetes Risk Among Women Over the Age of 65 Years: The OPACH Study
Bellettiere, J., LaMonte, M. J., Healy, G. N., Liles, S., Evenson, K. R., Di, C., Kerr, J., Lee, I.-M. M., Rillamas‐Sun, E., Büchner, D. M., et al. (2020) · Diabetes Care · doi:10.2337/dc20-0709 · Cited by 39
Metadata
- Authors
- The Diabetes Prevention Program Research Group [Prepared by Jill Crandall, D. S.
- Corresponding author
- The Diabetes Prevention Program Research Group [Prepared by Jill Crandall, David Schade, Yong Ma, Wilfred Y. Fujimoto, Elizabeth Barrett-Connor, Sarah Fowler, Sam Dagogo-Jack, Reubin Andres
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-10-01
- Volume
- 61
- Issue
- 10
- Pages
- 1075-1081
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC1783677
- OpenAlex
- W1508260332
- Semantic Scholar
- 2c6e5b4bb6f1081ba76996200c867a5a41120710
- Cited by
- 254
- References
- 46
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 14 · 2022: 7 · 2021: 10 · 2020: 8 · 2019: 11 · 2018: 15 · 2017: 13 · 2016: 15 · 2015: 16 · 2014: 14 · 2013: 15 · 2012: 26
- FWCI
- 10.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Diabetes Association
- Bristol-Myers Squibb
- George Washington University
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute on Aging
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048400, U01DK048411, 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
- type 2 diabetes prevention, age differences, intensive lifestyle intervention, metformin, Diabetes Prevention Program, older adults, weight loss, physical activity, insulin sensitivity, insulin secretion, diabetes incidence
- MeSH terms
- Adult, Age Factors, Aged, Diabetes Mellitus, Type 2, Female, Glucose, Humans, Hypoglycemic Agents, Life Style, Male, Metformin, Middle Aged, Incidence
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