Cited by 1,171Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsPharmacology and Obesity Treatment

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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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Gillies, Clare L, Abrams, Keith R, Lambert, Paul C, Cooper, Nicola J, Sutton, Alex J, Hsu, Ron T, Khunti, Kamlesh·2007·BMJ

DOI 10.1136/bmj.39063.689375.55PMC PMC1796695

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Abstract

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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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
ORCID: Gillies, Clare L
Abrams, Keith R
Lambert, Paul C
Cooper, Nicola J
Sutton, Alex J
Khunti, Kamlesh
Venue: BMJ
Publisher: BMJ
Published: 2007-01-19
Volume: 334
Issue: 7588
Pages: 299
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.39063.689375.55
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
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
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 (medical) › 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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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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