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Saturday, 6 April 2019

Diabetes Prevention Program (DPP)15 years follow-up. April 6, 2019

Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin

by Diabetes Prevention Program Research Group

 February 7, 2002
N Engl J Med 2002; 346:393-403
DOI: 10.1056/NEJMoa012512
https://www.nejm.org/doi/full/10.1056/NEJMoa012512 
Now 15 years after  researchers follow - up participants of the studies. It is very loudly presented that Metformin and Life Style Intervention prevent diabetes type 2 development.
 The DPPOS has continued to follow most DPP participants since 2002. To date, the DPPOS has shown that participants who took part in the DPP Lifestyle Change Program or are taking metformin continue to prevent or delay type 2 diabetes for at least 15 years.
Let us take a look at the official results of continued the studies.
 After about 3 years, the DPP showed that participants in the DPP Lifestyle Change Program lowered their chances of developing type 2 diabetes by 58 percent compared with participants who took a placebo (a pill without medicine).
       What is this? Double blind results? I do not know. I just try to understand what published, and it still unclear for me. 58% of participants lowered their chance ( did they missed the chance? Or really what is this?) of developing diabetes type 2. So, 42% took this chance and developed type 2 diabetes  three years after studies. But no, it is not just 42 %  who developed diabetes type 2. It is % compare with those who took a placebo. How many participants who took placebo developed diabetes type 2?
About 5 percent of participants in the DPP Lifestyle Change Program developed diabetes each year during the study compared with 11 percent of participants who took a placebo.   
How many participants developed diabetes type 2 15 years later?
1st year - 5%
2nd years - 5% of those who developed diabetes type 2 one year later + 5% out of 95% remaning without diabetes type 2 develpment.
3rd year - 5% of all participants + 5% out of 95% + 5% out of those who remanded without diabetes development three years later.
4 th years  - 5% out of 100% + (5% + 5% out of 100% - 5%) + (5% + 5% + 5% out of (100% - 5%) + 5% + .... I really lost. Please do the rest.
At least 5% for 15 years it is already 75% of all participants would develop diabetes type 2 15 years later. Now the question is, is this program really prevent diabetes type 2 development? The initial participants were not diabetics. 15 years later 75% of all participants developed diabetes type 2. At least, but real number is higher. The question still stand if there were any participants who did not developed diabetes type 2 with diabetes Prevention Program?
Participants who took metformin lowered their chances of developing type 2 diabetes by 31 percent compared with participants who took a placebo. Metformin was effective for all participating racial and ethnic groups and both men and women. Metformin was most effective in women with a history of gestational diabetes, in people between the ages of 25 and 44, and in people with obesity who had a body mass index of 35 or higher.
       As I said many times, I trust in no one. So, I took my studies, long time ago. At that time I took Metformin, and I was really very very ill. I did not know why I was so ill and weak. But I tried to find way out. What if my condition resulted by medicine I took at that time? I stopped to take all medicine all together, and then started to add one by one. When I added Metformin back to my medical box, my sugar got up. I was free from Metformin for awhile. Now I restarted it.  Sugar level increased.  I stopped Metformin, and level of sugar dropped. Also another problems with health got easy, and started to improve. At that time I started to take insulin. So, I stopped Metformin.
     After a few month I re-started metformin, and I got poison effect, very severe headache. Level of sugar run up. I stopped metformin, and never re-started it after.
     This is my point. In stead to trust in studies, if one has elevated level of sugar then stop to take metformin and see what would happen. If level of sugar return back to normal or get somehow down, then Metformin is not medicine for you. Very simple and very effective way to check up medicine how medicine effect your health and well being. Just run your studies.
 The DPP was a randomized, controlled clinical trial conducted at 27 clinical centers around the United States from 1996 to 2001. The trial enrolled 3,234 participants; 55 percent were Caucasian, and 45 percent were from minority groups at high risk for the disease, including African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander. The trial also recruited other groups at high risk for type 2 diabetes, including people ages 60 and older, women with a history of gestational diabetes, and people with a parent, brother, sister, or child who had type 2 diabetes.

10-Year Findings

participants who took part in the DPP Lifestyle Change Program continued to have a delay in the development of diabetes by 34 percent—and developed diabetes about 4 years later

 participants who continued to take metformin had a delay in the development of diabetes by 18 percent—and developed diabetes about 2 years later—

the DPP Lifestyle Change Program was shown to be cost-effective and metformin was shown to be cost-saving.  

about half (55 percent) of participants from the DPP Lifestyle Change Program and 56 percent of participants who continued to take metformin developed diabetes compared with 62 percent of participants who took a placebo.
But really, how this support the theory that metformin prevent diabetes type 2 development? Why people took metformin and life style intervention? There were fooled that this program and these actions will stop diabetes. It is not. It never was, it never will.
about half (55 percent) of participants from the DPP Lifestyle Change Program and 56 percent of participants who continued to take metformin developed diabetes compared with 62 percent of participants who took a placebo.
What I do suggest, add-on the group people who has elevated level of sugar but still not diagnosed with diabetes type 2, and treat them with insulin. Then compare results, how many of those in risk will develop diabetes type 2. No Life style intervention, no insulin, no placebo. Just level of sugar in blood, A1c, and dose of insulin. Follow up one year, two, three, five, 10, 15 years. Just let us see, what really prevent diabetes type 2 development:
life style modification?
Metformin?
Insulin?
Stop to fool around with all the %. Simple say, the number of participants in group, what treatment participants take, and how many of participants in every group developed diabetes type 2, or improved A1c level.  Simple, clear, reliable studies.
     There is no studies like this. Ned. Pro know too well where they do have money flow. They need us, they need to treat us, and no one of them need healthy people. For this reason Metformin is very good. It does not kill right away, so people can take it long, as long as about ten years. Diabetics develop CVD, strokes, you name it, diabetics type 2 do have it. Also we do have very unpleasant body form. Easy to blame, easy to abuse and to mock. Most important is to keep diabetics on the tight hook. For this reason all med media Shrek right now how good metformin is.
Source of information:
https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp


via Ravenvoron

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