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.
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 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 ¼ .07)”
- Also stated in: § RESULTS · hedged
“In contrast, diabetes incidence in the metformin group was lowest among the youngest participants (6.7 vs 7.7 vs 9.3 cases per 100 person-years; p trend ¼ .07), a trend that was of borderline significance.”
§ 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
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.
- Also stated in: § RESULTS · hedged
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.
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
“For the ILS group, diabetes risk in the 60-85 year age group was approximately one half that in the 25-44 year age group (hazard ratio, 0.47; 95% confidence interval [CI], 0.28-0.78);”
§ 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: 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
“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.”
§ 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
“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 ¼ .007).”
- Also stated in: § RESULTS · plain
“Although ILS was effective in all age groups, diabetes incidence rates fell with increasing age (6.3 vs 4.9 vs 3.3 cases per 100 person-years in the 25-44, 45-59, and 60-85 year age groups, respectively; p trend ¼ .007).”
§ 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
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.
- 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
“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
“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
“and there was little change following adjustment for baseline glucose, insulin sensitivity, and insulin secretion (hazard ratio, 0.50; 95% CI, 0.29-0.89).”
§ 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: 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
“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: 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
“ILS became significantly more effective than metformin with increasing age ( p ¼ .005).”
§ 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
“Although baseline glucose variables were almost identical in the three age groups, the strength of the association between age and declining metformin effect was attenuated when the small differences in baseline fasting glucose values (106 vs 107 mg/dL, in the 25-44 and 60-85 year age groups, respectively) were included in the model.”
§ 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.
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 trend was attenuated following adjustment for baseline metabolic parameters (hazard ratio, 1.26; 95% CI, 0.80-1.93)”
§ 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.
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
“As expected, younger participants were more likely to be employed (85% vs 82% vs 39%) and to live in households with four or more members (50% vs 29% vs 12%).”
§ 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: 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
“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 > DISCUSSION
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
“After adjusting for time-dependent change in weight, calorie intake, and activity, the age difference disappeared (hazard ratio, 0.83; 95% CI, 0.46-1.50).”
§ 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: 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
“As expected, younger participants were more likely to be employed (85% vs 82% vs 39%) and to live in households with four or more members (50% vs 29% vs 12%).”
§ 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: 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
“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
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.
In the paper
“among those participants who developed diabetes during the DPP, the youngest group was more likely to convert by fasting criteria (62% vs 53% vs 45%), and the oldest group by 2-hour criteria (38% vs 47% vs 55%; p , .01), an observation consistent with previous reports (22).”
§ 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 [22] source
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.
In the paper
“among those participants who developed diabetes during the DPP, the youngest group was more likely to convert by fasting criteria (62% vs 53% vs 45%), and the oldest group by 2-hour criteria (38% vs 47% vs 55%; p , .01), an observation consistent with previous reports (22).”
§ 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 [22] source
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.
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 baseline glucose variables were almost identical in the three age groups, the strength of the association between age and declining metformin effect was attenuated when the small differences in baseline fasting glucose values (106 vs 107 mg/dL, in the 25-44 and 60-85 year age groups, respectively) were included in the model.”
- Also stated in: § RESULTS · plain
“Baseline fasting plasma glucose and 2-hour glucose were similar in all 3 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 > 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.
- 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
“Baseline fasting plasma glucose and 2-hour glucose were similar in all 3 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
“This pattern was most apparent in the metformin 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 > 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.
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 risk reduction did not differ by ethnic 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 > 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.
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 | Weight change, kg | À1.5 (0.3) | À1.7 (0.2) | À2.7 (0.3) | .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: 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 change, kg | À4.1 (0.4) À5.0 (0.3) À6.4 (0.3) ,.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: 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 diabetes risk reduction did not differ significantly (62% for men vs 52% for women; p ¼ .25).”
§ 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: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Metformin reduced the development of diabetes by 30%, and lifestyle modification did so by 55% in the cohort as a whole (1,9).”
§ 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
What the sources say
- Not checked yetcites [1] source
- Not checked yetcites [9]
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.
In the paper
“Within the metformin group, those participants with the highest insulin sensitivity and lowest insulin secretion (the pattern typical of older adults) had a greater hazard ratio for diabetes than did those participants with the lowest insulin sensitivity and greatest insulin secretion (typical of younger adults) (9).”
§ 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 [9]
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.
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 limited effectiveness of metformin in older persons may reflect age-related differences in insulin action and 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 > Abstract
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.
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
“One explanation for these results is a ''survivor effect''-that is, those persons who survived to a later age without developing diabetes tended to be somewhat leaner and less insu-lin resistant than were age-mates who did become diabetic.”
§ 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Metformin reduced the development of diabetes by 30%, and lifestyle modification did so by 55% in the cohort as a whole (1,9).”
§ 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
What the sources say
- Not checked yetcites [1] source
- Not checked yetcites [9]
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 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
“Nonetheless, the pattern of decreased metformin effect with age suggests that there may be true differences in physiology and pharmacologic response.”
§ 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.
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 results appear to be due to more active participation in ILS activities by the older group, although other (biological) factors are suggested by their better baseline body size and glycemic profile and the stronger effect on postchallenge glycemia.”
§ 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.
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 modification was exceptionally effective in preventing diabetes in older individuals; this finding was largely explained by greater weight loss and physical activity.”
§ 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
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 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 results appear to be due to more active participation in ILS activities by the older group, although other (biological) factors are suggested by their better baseline body size and glycemic profile and the stronger effect on postchallenge glycemia.”
§ 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
hedgeddirect- 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 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, our data suggest that the effectiveness of a comprehensive ILS program in preventing deterioration of glucose tolerance is enhanced 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
hedgeddirect- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“The Diabetes Prevention Program (DPP) demonstrated that an intensive lifestyle intervention (ILS) or metformin could prevent or delay diabetes.”
- Also stated in: § Abstract · boosted
“The Diabetes Prevention Program (DPP), a multicenter, randomized, controlled trial, demonstrated that medication (metformin) or lifestyle modification could prevent or delay the development of diabetes in a high-risk population who had IGT and an elevated fasting glucose.”
§ 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
What the sources say
- Not checked yetcites [1] source
- Not checked yetcites [9]
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.
- Also stated in: § Abstract · boosted
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 modification was exceptionally effective in preventing diabetes in older individuals; this finding was largely explained by greater weight loss and physical activity.”
§ 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
boosteddirectn = 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.
In the paper
“As reported previously (9), baseline insulin sensitivity and secretion were strong and independent predictors of diabetes risk in the 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
What the sources say
- Not checked yetcites [9]
boostedcorrelational- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“In contrast, the effect of aerobic (endurance) training on insulin sensitivity in the elderly population is uncertain, with some reporting a clear benefit (36,37) and others no effect, despite increased muscle GLUT4 and mitochondrial oxidative capacity (38).”
§ 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 [36] source
- Not checked yetcites [37]
- Not checked yetcites [38]
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 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
“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
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.
In the paper
“Several studies in older patients with type 2 diabetes suggested that resistance training can improve glycemic control and insulin sensitivity, independent of weight loss (32)(33)(34).”
§ 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 (32)(33)(34)
hedgedconditional- 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.
In the paper
“In that study, older adults (>65 years) had substantially accelerated rates of progression to abnormal 2-hour glucose compared to younger persons.”
§ 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 [22] source
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.
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
“so these results may not apply to frail or disabled elderly persons.”
§ 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
hedged- 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.
- Rests on an assumption: The DPP cohort was a relatively healthy and motivated group.
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 study had limited power to detect these differences”
§ 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: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 limited effectiveness of metformin, in contrast, may reflect true age-related differences in glucose metabolism and glycemic patterns at diabetes conversion.”
§ 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.
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
“In conclusion, results of the DPP demonstrate that an intensive lifestyle modification program is exceptionally effective in preventing diabetes in older individuals with IGT.”
§ 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
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.
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 pattern was most apparent in the metformin group, and is consistent with the relative ineffectiveness of this agent in reducing postchallenge hyperglycemia.”
§ 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.
In the paper
“In the Rancho Bernardo Study, isolated postchallenge hyperglycemia was much more common than fasting hyperglycemia as a diagnostic criterion for diabetes (4).”
§ 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 [4] source
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.
In the paper
“Data from the Baltimore Longitudinal Study of Aging suggest that there may be two distinct phenotypes for the development of diabetes-one through increased fasting glucose and the other through elevated 2-hour glucose levels (22).”
§ 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 [22] source
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.
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 robust response is in large part due to greater weight loss and more active participation in ILS activities among the 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
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 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
“suggesting that the observed age differences in treatment effects are unlikely to be explained solely by variations in sex and ethnic composition of 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 > DISCUSSION
hedged- 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 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
“and this may have been a factor in the borderline statistical significance of some of our findings.”
§ 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.
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
“has broad potential applicability for community-dwelling seniors.”
§ 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: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The DPP ILS program was well-tolerated by older participants.
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 numbers also preclude meaningful stratified analyses to examine the effect of unequal ethnic and sex distributions in some 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 > 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.
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
“We propose that reduced metformin effectiveness in preventing diabetes in the elderly population may be due to the interaction of a specific metabolic profile (insulin secretory defect, leading to postchallenge hyperglycemia) with the drug's pharmacologic action.”
§ 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. 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.
- 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.
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.
- 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
“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.
- 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
“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.
- 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.
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
Cites
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297
A Simple Sequentially Rejective Multiple Test Procedure
(1979) · Scandinavian Journal of Statistics · doi:10.2307/4615733 · Cited by 21,526
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873 · cited 1×
“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.”
BackgroundLittell, R. C. (1996) · Medical Entomology and Zoology · Cited by 10,345
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus* (2002) · Diabetes Care · doi:10.2337/diacare.25.2007.s5 · Cited by 10,325
Everitt, B. S. (2001) · Psychology Press eBooks · doi:10.4324/9781410605542-11 · Cited by 6,877
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) · Diabetes Care · doi:10.2337/diacare.20.7.1183 · Cited by 6,220
Pan, X.-R., Li, G.-W., Hu, Y.-H., Wang, J.-X., Yang, W.-Y., An, Z.-X., Hu, Z.-X., Juan-Lin, Xiao, J.-Z., Cao, H.-B., et al. (1997) · Diabetes Care · doi:10.2337/diacare.20.4.537 · Cited by 4,320
Research works printed but not linked: 4
- 2005, Diabetes, 54, 2402
- 1997, Medicine and Science in Sports and Exercise, 29, S5
- 1979, SCANDINAVIAN J STATISTICS, 6, 65
- 1990, American Journal of Physiology -- Legacy Content, 258, E937
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
Kirkman, M. S., 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) · Diabetes Care · doi:10.2337/dc12-1801 · Cited by 1,274
Type 2 diabetes mellitus in older adults: clinical considerations and management
Bellary, S., Kyrou, I., Brown, J. E., & Bailey, C. J. (2021) · Nature Reviews Endocrinology · doi:10.1038/s41574-021-00512-2 · Cited by 639
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
Perreault, L., Pan, Q., Mather, K. J., Watson, K. E., Hamman, R. F., & Kahn, S. E. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60525-x · Cited by 532
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
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.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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