Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults With Prediabetes.
Lifestyle intervention linked to lower multimorbidity risk in prediabetes, unlike metformin
Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults With Prediabetes.
IMPORTANCE: Studying how to prevent or delay not just 1 disease but multiple chronic conditions is of great importance for public health; however, few interventions have demonstrated success during long-term follow-up.
To examine the association of lifestyle or metformin compared with placebo on long-term multimorbidity in adults with prediabetes.
DESIGN, SETTING, AND PARTICIPANTS: Observational follow-up cohort study of a randomized clinical trial conducted at 27 sites in the United States from June 1, 1996, to December 31, 2021.
lower long-term risk of multiple chronic conditions with lifestyle vs placebo
Of the 1173 participants (median age, 74 years [IQR, 70-80]; 795 [68%] were female), 997 (85%) experienced greater than or equal to 2 conditions (median, 5 [IQR, 3-7]) by the end of follow-up (316 of 385 [82%], 327 of 385 [85%], and 350 of 403 [87%], respectively, among lifestyle, metformin, and placebo groups).
There was no difference between participants in the metformin and placebo groups (HR, 0.91; 95% CI, 0.78-1.07).
These relationships persisted when diabetes was excluded from the multimorbidity definition.
When restricted to dyads of the costliest conditions, the association with lifestyle vs placebo yielded an HR of 0.57 (95% CI, 0.38-0.85).
Among adults with prediabetes at baseline, lifestyle intervention, but not metformin, was associated with a lower burden of multimorbidity. Lifestyle programs may persistently lower the development of chronic conditions.