Impact of Metformin Plus Lifestyle Intervention Compared With Lifestyle Intervention Alone on Prediabetes Remission in Participants With Impaired Glucose Regulation: The China DPP Study.
Siyao He, Yongmei Hao, Ping Tu et al.
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In 30 seconds
This secondary analysis of the multicentre, unblinded China Diabetes Prevention Program randomised trial compared metformin plus lifestyle intervention with lifestyle intervention alone in Chinese adults aged 18–70 years with impaired glucose regulation. Over a median follow-up of 2.03 years, prediabetes remission occurred in 31.5% of the metformin-plus-lifestyle group and 25.1% of the lifestyle-only group. After adjustment for baseline characteristics, adding metformin was associated with a higher remission rate (HR 1.39, 95% CI 1.16-1.67, p < 0.001), with similar effects across subgroups.
Key findings
- Remission occurred in 262/831 (31.5%) participants receiving metformin plus lifestyle intervention versus 213/847 (25.1%) receiving lifestyle intervention alone.
- Adjusted analysis found a higher remission rate with added metformin (HR 1.39, 95% CI 1.16-1.67, p < 0.001).
- Higher baseline HbA1c was associated with lower remission rates (HR 0.23, 95% CI 0.18-0.29, p < 0.001).
Why it matters
Prediabetes remission is a clinically relevant outcome in a population at increased risk of cardiovascular disease and mortality. These trial findings suggest that adding metformin to lifestyle intervention can improve the likelihood of remission compared with lifestyle intervention alone, providing evidence to inform prediabetes management in Chinese adults with impaired glucose regulation.
What to keep in mind
This was a secondary analysis of an unblinded trial, and follow-up was relatively short, with a median of 2.03 years.