Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis
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OBJECTIVE: To quantify the effectiveness of pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance. DATA SOURCES: Medline, Embase, and the Cochrane library searched up to July 2006. Expert opinions sought and reference lists of identified studies and any relevant published reviews checked. STUDY SELECTION: Randomised controlled trials that evaluated interventions to delay or prevent type 2 diabetes in individuals with impaired glucose tolerance. RESULTS: 21 trials met the inclusion criteria, of which 17, with 8084 participants with impaired glucose tolerance, reported results in enough detail for inclusion in the meta-analyses. From the meta-analyses the pooled hazard ratios were 0.51 (95% confidence interval 0.44 to 0.60) for lifestyle interventions v standard advice, 0.70 (0.62 to 0.79) for oral diabetes drugs v control, 0.44 (0.28 to 0.69) for orlistat v control, and 0.32 (0.03 to 3.07) for the herbal remedy jiangtang bushen recipe v standard diabetes advice. These correspond to numbers needed to treat for benefit (NNTB) and harm (NNTH) of 6.4 for lifestyle (95% credible interval, NNTB 5.0 to NNTB 8.4), 10.8 for oral diabetes drugs (NNTB 8.1 to NNTB 15.0), 5.4 for orlistat (NNTB 4.1 to NNTB 7.6), and 4.0 for jiangtang bushen (NNTH 16.9 to NNTB 24.8). CONCLUSIONS: Lifestyle and pharmacological interventions reduce the rate of progression to type 2 diabetes in people with impaired glucose tolerance. Lifestyle interventions seem to be at least as effective as drug treatment.
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The DPPOS finding that lifestyle and metformin delayed or prevented diabetes agrees with other reports of similar lifestyle or antidiabetic drug interventions.
“Our findings that both lifestyle and metformin interventions delayed or prevented diabetes in the DPPOS are consistent with results of other reports of similar interventions with lifestyle or with other antidiabetic drugs.24,25”
From 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study (2009) · cites this paper as [25]
Sixteen of the systematic reviews included exclusively people with intermediate hyperglycaemia.
“Sixteen of these systematic reviews included exclusively people with intermediate hyperglycaemia (Aguiar 2014; Gillett 2012; Gillies 2007; Glechner 2015; Gong 2015; Hopper 2011; ICER 2016; Norris 2005; Santaguida 2005; Selph 2015; Stevens 2015; Yamaoka 2005; Yates 2007; Yoon 2013; Yuen 2010; Zheng 2016);”
From Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus (2017) · cites this paper as Gillies 2007
Lifestyle and pharmacological interventions reduced the rate of progression to type 2 diabetes in people with impaired glucose tolerance, and these interventions seem as effective as pharmacological treatment.
“In their systematic review, Gillies et al. found that lifestyle and pharmacological interventions reduced the rate of progression to type 2 diabetes in people with IGT and that these interventions seem to be as effective as pharmacological treatment.”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [5]
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- Authors
- Gillies, C. L., Abrams, K. R., Lambert, P. C., Cooper, N. J., Sutton, A. J., Hsu, R. T., & Khunti, K.
- Affiliations
- University of Leicester (GB)
- Corresponding author
- Gillies, Clare L
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-01-19
- Volume
- 334
- Issue
- 7588
- Pages
- 299
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1796695
- OpenAlex
- W2096691922
- Cited by
- 1,171
- References
- 43
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 38 · 2023: 38 · 2022: 40 · 2021: 47 · 2020: 56 · 2019: 56 · 2018: 51 · 2017: 78 · 2016: 74 · 2015: 75 · 2014: 98 · 2013: 97 · 2012: 100
- FWCI
- 9.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Medical Research Council
- Economic and Social Research Council
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- type 2 diabetes prevention, impaired glucose tolerance, lifestyle intervention, pharmacological interventions, oral antidiabetic drugs, orlistat, diabetes progression, number needed to treat
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Life Style, Randomized Controlled Trials as Topic, Treatment Outcome, Publication Bias, Glucose Intolerance
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