A long-term follow-up of the Diabetes Prevention Program found that participants originally assigned to an intensive lifestyle programme were less likely to develop multiple chronic conditions than those assigned to placebo.
The finding concerns multimorbidity—having at least two of the conditions studied. It should not be read as proof that the programme independently prevented every disease listed in our earlier report.
What the researchers measured
The JAMA study analysed linked Medicare data for 1,173 participants in an observational follow-up of the original randomised trial. By the end of follow-up, two or more conditions had been recorded in 82% of the lifestyle group, 85% of the metformin group and 87% of the placebo group.
The adjusted hazard ratio for lifestyle intervention versus placebo was 0.79, with a 95% confidence interval of 0.68–0.93. The metformin comparison did not show a statistically significant reduction in this outcome.
What the lifestyle programme involved
George Washington University’s account describes goals of at least 150 minutes of physical activity a week and losing at least 7% of initial body weight through changes in diet and activity. Those were programme goals, not a statement that every participant achieved them.
The analysis covered records through 2021 and examined 15 conditions. Its findings remained similar when diabetes was excluded from the definition of multimorbidity.
Limits and practical meaning
The paper notes limits involving the selected participant population, changes in treatment exposure over time and the use of claims to identify illness. A lower combined disease burden is not the same finding as a demonstrated reduction in each individual condition.
NIDDK defines prediabetes as blood glucose above the normal range but below the threshold for a diabetes diagnosis. Readers can discuss testing and a suitable prevention programme with their health professional.
Correction September 25, 2026: We corrected the definition of prediabetes, added the study population and results, and removed claims that the analysis demonstrated separate reductions in heart disease, kidney disease and nerve damage.