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Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with impaired glucose tolerance (IGT).

The answer is yes. In fact, the DPP found that over the three years of the study, diet and exercise sharply reduced the chances that a person with IGT would develop diabetes. Metformin also reduced risk, although less dramatically. The DPP resolved these questions so quickly that, on the advice of an external monitoring board, the program was halted a year early. The researchers published their findings in the Feb. 7, 2002, issue of the New England Journal of Medicine.

Did You Know?

Under the Affordable Care Act, many health insurance plans will cover preventive care services, including screening tests for type 2 diabetes, at no cost to you. Learn more.

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DPP Study Design and Goals

In the DPP, participants from 27 clinical centers around the country were randomly split into different treatment groups. The first group, called the lifestyle intervention group, received intensive training in diet, exercise, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7% of their body weight and maintain that loss.

The second group took 850 milligrams of metformin twice a day. The third group received placebo pills instead of metformin. The metformin and placebo groups also received information on diet and exercise, but no intensive counseling efforts. A fourth group was treated with the drug Rezulin (troglitazone), but this part of the study was discontinued after researchers discovered that Rezulin could cause serious liver damage.

All 3,234 study participants were overweight and had IGT, which are well-recognized risk factors for the development of type 2 diabetes. In addition, 45% of the participants were from minority groups – African-American, Hispanic American/Latino, Asian American or Pacific Islander, or American Indian -- that are at increased risk of developing diabetes.

Type 2 Diabetes and Prediabetes

Diabetes is a disorder that affects the way your body uses digested food for growth and energy. Normally, the food you eat is broken down into sugar (glucose). The glucose then passes into your bloodstream, where it is used by your cells for growth and energy. For glucose to reach your cells, however, insulin must be present. Insulin is a hormone produced by your pancreas, a hand-sized gland behind your stomach.

Most people with type 2 diabetes have two problems: The pancreas may produce too much insulin that your body cannot efficiently use. Later in the disease, the pancreas may not produce enough insulin; therefore fat, muscle, and liver cells are deprived of insulin and unable to access the glucose needed to function as the glucose remains in the bloodstream. This means that sugar builds up in the blood, overflows into the urine, and passes out of the body -- without fulfilling its role as the body's main source of fuel. Both too much insulin and too much glucose in the blood (instead of in the cells where needed), can damage blood vessels and tissues.

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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