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1. Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience.

Author

White, Neil, Pan, Qing, Knowler, William, Schroeder, Emily, Dabelea, Dana, Chew, Emily, Blodi, Barbara, Goldberg, Ronald, Pi-Sunyer, Xavier, Darwin, Christine, Schlögl, Mathias, and Nathan, David

Subjects
Adult, Humans, Prediabetic State, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Glycated Hemoglobin, Blood Glucose, Risk Factors
Abstract

OBJECTIVE: To determine glycemic and nonglycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time in adults at high risk for developing T2D, including after they developed diabetes. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye. RESULTS: By DPPOS year 16 (∼20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20-0.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46-1.74 per SD [0.7%] increase in HbA1c). CONCLUSIONS: DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D.

Published
2022

2. The 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) score and diabetes risk in the Diabetes Prevention Program Outcomes Study (DPPOS)

Author

Shams-White, Marissa M, Tjaden, Ashley H, Edelstein, Sharon L, Bassiouni, Sarah, Kahle, Lisa L, Kim, Catherine, Pi-Sunyer, Xavier, Temple, Karla A, Venditti, Elizabeth M, Reedy, Jill, and Heckman-Stoddard, Brandy M

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Prevention, Clinical Trials and Supportive Activities, Cancer, Nutrition, Clinical Research, Diabetes, Metabolic and endocrine, Good Health and Well Being, Alcohol, Diet, Disease prevention, Obesity, Physical activity, Weight, DPP Research Group, Nutrition and dietetics
Abstract

BackgroundThe 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 3rd expert report highlights up-to-date Cancer Prevention Recommendations that may reduce burdens of many chronic diseases, including diabetes. This study examined if following a lifestyle that aligns with the recommendations - assessed via the 2018 WCRF/AICR Score - was associated with lower risk of type 2 diabetes in high-risk adults participating in the Diabetes Prevention Program Outcomes Study (DPPOS).MethodsThe Diabetes Prevention Program (DPP) randomized adults at high risk for diabetes to receive a lifestyle intervention (ILS), metformin (MET) or a placebo (PLB) (mean: 3.2 years), with additional follow-up in DPPOS for 11 years (mean: 15 years total). 2018 WCRF/AICR Scores included seven components: body weight, physical activity, plant-based foods, fast foods, red and processed meat, sugar-sweetened beverages, and alcohol; the optional breastfeeding component was excluded. Scores ranged 0-7 points (with greater scores indicating greater alignment with the recommendations) and were estimated at years 0, 1, 5, 6, 9, and 15 (N=3,147). Fasting glucose and HbA1c were measured every six months and oral glucose tolerance tests were performed annually. Adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were used to examine the association of both Score changes from years 0-1 and time-dependent Score changes on diabetes risk through DPP and year 15.ResultsScores improved within all groups over 15 years (p

Published
2022

3. Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Author

Lee, Christine G, Heckman-Stoddard, Brandy, Dabelea, Dana, Gadde, Kishore M, Ehrmann, David, Ford, Leslie, Prorok, Philip, Boyko, Edward J, Pi-Sunyer, Xavier, Wallia, Amisha, Knowler, William C, Crandall, Jill P, Temprosa, Marinella, Group:, Diabetes Prevention Program Research, Bray, George A, Culbert, Iris W, Arceneaux, Jennifer, Chatellier, Annie, Dragg, Amber, Champagne, Catherine M, Duncan, Crystal, Eberhardt, Barbara, Greenway, Frank, Guillory, Fonda G, Herbert, April A, Jeffirs, Michael L, Kennedy, Betty M, Levy, Erma, Lockett, Monica, Lovejoy, Jennifer C, Morris, Laura H, Melancon, Lee E, Ryan, Donna H, Sanford, Deborah A, Smith, Kenneth G, Smith, Lisa L, St. Amant, Julia A, Tulley, Richard T, Vicknair, Paula C, Williamson, Donald, Zachwieja, Jeffery J, Polonsky, Kenneth S, Tobian, Janet, Ehrmann, David A, Matulik, Margaret J, Temple, Karla A, Clark, Bart, Czech, Kirsten, DeSandre, Catherine, Dotson, Brittnie, Hilbrich, Ruthanne, McNabb, Wylie, Semenske, Ann R, Caro, Jose F, Furlong, Kevin, Goldstein, Barry J, Watson, Pamela G, Smith, Kellie A, Mendoza, Jewel, Simmons, Marsha, Wildman, Wendi, Liberoni, Renee, Spandorfer, John, Pepe, Constance, Donahue, Richard P, Goldberg, Ronald B, Prineas, Ronald, Calles, Jeanette, Giannella, Anna, Rowe, Patricia, Sanguily, Juliet, Cassanova-Romero, Paul, Castillo-Florez, Sumaya, Florez, Hermes J, Garg, Rajesh, Kirby, Lascelles, Lara, Olga, Larreal, Carmen, McLymont, Valerie, Mendez, Jadell, Perry, Arlette, Saab, Patrice, Veciana, Bertha, Haffner, Steven M, Hazuda, Helen P, Montez, Maria G, Hattaway, Kathy, Isaac, Juan, Lorenzo, Carlos, Martinez, Arlene, Salazar, Monica, Walker, Tatiana, Hamman, Richard F, Nash, Patricia V, Steinke, Sheila C, Testaverde, Lisa, Truong, Jennifer, and Anderson, Denise R

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Clinical Sciences, Prevention, Clinical Trials and Supportive Activities, Nutrition, Clinical Research, Cancer, Cardiovascular, Diabetes, Aetiology, 2.2 Factors relating to the physical environment, Good Health and Well Being, Adult, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Life Style, Metformin, Diabetes Prevention Program Research Group, Diabetes Prevention Program Research Group:, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveTo determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.Research design and methodsFrom 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively.ResultsOver a median of 21 years (interquartile range 20-21), 453 participants died. Cancer was the leading cause of death (n = 170), followed by cardiovascular disease (n = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality.ConclusionsCancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.

Published
2021

4. Impact of Body Weight Dynamics Following Intentional Weight Loss on Fracture Risk: Results from The Action for Health in Diabetes Study

Author

Beavers, Kristen M, Neiberg, Rebecca H, Johnson, Karen C, Davis, C Hunter, Casanova, Ramon, Schwartz, Ann V, Crandall, Carolyn J, Lewis, Cora E, Pi‐Sunyer, Xavier, Kritchevsky, Stephen B, and Group, the Look AHEAD Research

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Osteoporosis, Nutrition, Women's Health, Clinical Research, Obesity, Aging, Prevention, Diabetes, Metabolic and endocrine, Musculoskeletal, WEIGHT CHANGE, WEIGHT VARIABILITY, FRACTURE, BMD, TYPE 2 DIABETES, Look AHEAD Research Group, Biomedical and clinical sciences
Abstract

The purpose of this study is to explore the impact of body weight change following intentional weight loss on incident fracture and bone mineral density (BMD) in overweight and obese adults with diabetes. A total of 1885 individuals with type 2 diabetes (baseline age: 58.5 ± 6.7 years, 58% women, body mass index: 35.7 ± 6.0 kg/m2) who participated in the Look AHEAD study and lost any weight 1 year after being randomized to an intensive lifestyle intervention were assessed. Body weight was measured annually and participants were categorized as weight regainers, weight cyclers, or continued losers/maintainers based on a ±3% annual change in weight from year 1 to year 4. Adjudicated overall fracture incidence was captured from years 4 through 13 (median follow-up duration 11.5 years). Hip and spine BMD was assessed in a subset of participants at baseline, year 4 (n = 468), and year 8 (n = 354), using dual-energy X-ray absorptiometry. Cox proportional hazards and linear regression models, adjusted for relevant covariates, were performed for fracture and BMD outcomes, respectively. Fifty-eight percent, 22%, and 20% of participants were classified as weight regainers, weight cyclers, and continued losers/maintainers, respectively; and 217 fractures (men n = 63; women n = 154) were recorded during the follow-up period. There were no statistically significant differences in total incident fracture rates for weight regainers (HR [95% CI]: 1.01 [95% CI, 0.71 to 1.44]) or weight cyclers (HR [95% CI]: 1.02 [95% CI, 0.68 to 1.53]) when compared to continued losers/maintainers (p = 0.99). Similarly, follow-up BMD estimates did not significantly vary by weight pattern group, although consistent trends for lowered BMD in the hip region were noted for continued losers/maintainers and weight cyclers compared with weight regainers. Patterns of weight change in the 3 years following 1 year of intentional weight loss were not associated with subsequent fracture or significantly reduced BMD in this cohort of overweight and obese adults with type 2 diabetes. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Published
2019

5. Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium

Author

Redman, Leanne M., Drews, Kimberly L., Klein, Samuel, Horn, Linda Van, Wing, Rena R., Pi-Sunyer, Xavier, Evans, Mary, Joshipura, Kaumudi, Arteaga, S. Sonia, Cahill, Alison G., Clifton, Rebecca G., Couch, Kimberly A., Franks, Paul W., Gallagher, Dympna, Haire-Joshu, Debra, Martin, Corby K., Peaceman, Alan M., Phelan, Suzanne, Thom, Elizabeth A., Yanovski, Susan Z., and Knowler, William C.

Published
2021
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6. Research Priorities for Studies Linking Intake of Low-Calorie Sweeteners and Potentially Related Health Outcomes

Author

Bright, Oliver-John M, Wang, Ding Ding, Shams-White, Marissa, Bleich, Sara N, Foreyt, John, Franz, Marion, Johnson, Guy, Manning, Beth Trickett, Mattes, Rick, Pi-Sunyer, Xavier, Schneeman, Barbara, Parrott, James Scott, Steffen, Dan, Sylvetsky, Allison, Ziegler, Paula, and Chung, Mei

Subjects
Agricultural, Veterinary and Food Sciences, Biomedical and Clinical Sciences, Nutrition and Dietetics, Animal Production, Food Sciences, Nutrition, Generic health relevance, low-calorie sweeteners, artificial sweeteners, non-nutritive sweeteners, high-intensity sweeteners, future research needs, Animal production, Food sciences, Nutrition and dietetics
Abstract

Background: In a world of finite research funding, efforts to prioritize future research topics are increasingly necessary. Objective: The aim of this study was to identify and prioritize the direction of future research in the broad area of low-calorie sweetener (LCS) intake and potentially related health outcomes by using a novel method that incorporates evidence mapping in the Agency for Healthcare Research and Quality's Future Research Needs (FRN) process. Methods: A diverse expert stakeholder panel was convened and engaged to identify research gaps and prioritize future research needs. An independent research team hosted a number of interactive webinars and elicited feedback through surveys and individual interviews with the stakeholder panel, which included policymakers, lay audience members, health providers, a research funder, individuals with food industry experience, and researchers of several different specialties. Results: The stakeholder panel generated and ranked a list of 18 FRN questions across 5 broad research areas. Overall, stakeholder panel members unanimously agreed that the research questions that will have the largest public health impact are those that address outcomes related to body weight, appetite, and dietary intake. Although the LCSs included in this FRN project have all been Generally Recognized as Safe by the FDA or approved as food additives, the recurrent concerns and confusions with regard to the "safety" of LCSs by consumers underscore the importance of communicating the science to the general public. Conclusion: Our project provides evidence that engaging a diverse expert stakeholder panel is an effective method of translating gaps in nutrition research into prioritized areas of future research.

Published
2017

8. One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials

Author

Phelan, Suzanne, Clifton, Rebecca G., Haire-Joshu, Debra, Redman, Leanne M., Van Horn, Linda, Evans, Mary, Joshipura, Kaumudi, Couch, Kimberly A., Arteaga, S. Sonia, Cahill, Alison G., Drews, Kimberly L., Franks, Paul W., Gallagher, Dympna, Josefson, Jami L., Klein, Samuel, Knowler, William C., Martin, Corby K., Peaceman, Alan M., Thom, Elizabeth A., Wing, Rena R., Yanovski, Susan Z., and Pi-Sunyer, Xavier

Published
2020
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10. Metabolite signature of diabetes remission in individuals with obesity undergoing weight loss interventions.

Author

Thaker, Vidhu V., Kwee, Lydia Coulter, Chen, Haiying, Bahnson, Judy, Ilkayeva, Olga, Muehlbauer, Michael J., Wolfe, Bruce, Purnell, Jonathan Q., Pi‐Sunyer, Xavier, Newgard, Christopher B., Shah, Svati H., and Laferrère, Blandine

Subjects
GASTRIC banding, GASTRIC bypass, WEIGHT loss, DISEASE remission, FALSE discovery rate, GLYCOSYLATED hemoglobin, PRINCIPAL components analysis
Abstract

Objective: This observational study investigated metabolomic changes in individuals with type 2 diabetes (T2D) after weight loss. We hypothesized that metabolite changes associated with T2D‐relevant phenotypes are signatures of improved health. Methods: Fasting plasma samples from individuals undergoing bariatric surgery (n = 71 Roux‐en‐Y gastric bypass [RYGB], n = 22 gastric banding), lifestyle intervention (n = 66), or usual care (n = 14) were profiled for 139 metabolites before and 2 years after weight loss. Principal component analysis grouped correlated metabolites into factors. Association of preintervention metabolites was tested with preintervention clinical features and changes in T2D markers. Association between change in metabolites/metabolite factors and change in T2D remission markers, homeostasis model assessment of β‐cell function, homeostasis model assessment of insulin resistance, and glycated hemoglobin (HbA1c) was assessed. Results: Branched‐chain amino acids (BCAAs) were associated with preintervention adiposity. Changes in BCAAs (valine, leucine/isoleucine) and branched‐chain ketoacids were positively associated with change in HbA1c (false discovery rate q value ≤ 0.001) that persisted after adjustment for percentage weight change and RYGB (p ≤ 0.02). In analyses stratified by RYGB or other weight loss method, some metabolites showed association with non‐RYGB weight loss. Conclusions: This study confirmed known metabolite associations with obesity/T2D and showed an association of BCAAs with HbA1c change after weight loss, independent of the method or magnitude of weight loss. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Changes in body composition and metabolic disease risk

Author

Pi-Sunyer, Xavier

Subjects
Metabolic syndrome X -- Risk factors -- Prevention, Weight gain -- Health aspects, Physiological research, Cardiovascular diseases, Type 2 diabetes, Insulin, Insulin resistance, Liver, Food/cooking/nutrition, Health
Abstract

As individuals gain weight, they increase the amount of fat that they accrue on their body. This causes adipocytes to enlarge and increases not only subcutaneous fat but also deposits fat in other vulnerable areas of the body. This ectopic fat is deposited in the intra-abdominal visceral fat depot, in muscle, in the liver and in the beta cells. Fat in these locations initiates a dysfunctional state in these insulin-sensitive tissues leading to insulin resistance, the appearance of the Metabolic Syndrome, and an increased risk of developing both type 2 diabetes and cardiovascular disease. A loss of weight and with it a loss of fat decreases this risk., Author(s): Xavier Pi-Sunyer [sup.1] Author Affiliations: (1) Columbia University College of Physicians and Surgeons and Columbia Institute of Human Nutrition, New York, USA Introduction As individuals gain weight, they change [...]

Published
2019
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15. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial

Author

Hamann, Andreas, Barakat, Alain, Blüher, Matthias, Linn, Thomas, Mölle, Andrea, Segner, Alexander, Stübler, Petra, Tosch-Sisting, Regina, Pacini, Furio, Santini, Ferruccio, Marchesini, Giulio, Rotella, Carlo Maria, Invitti, Cecilia, Vettor, Roberto, Buscemi, Silvio, Raya, Pedro Mezquita, Freijoo, Felipe Casanueva, de Barbará, Ramón Gomis, Carraro, Raffaele, Bobillo, Enrique Romero, de la Cuesta, Carmen, Farsang, Csaba, Csaszar, Albert, Zahorska-Markiewicz, Barbara, Pupek-Musialik, Danuta, Franek, Edward, Ostrowska, Lucyna, Olszanecka-Glinianowicz, Magdalena, Lalic, Nebojsa, Micic, Dragan, Ludvik, Bernhard, Paulweber, Bernhard, Prager, Rudolf, Scheen, André, Van Gaal, Luc, Astrup, Arne Vernon, Hermansen, Kjeld, Madsbad, Sten, Rissanen, Aila, Nieminen, Sakari, Savolainen, Markku, Krempf, Michel, Romon, Monique, Laville, Martine, Marre, Michel, Mira, Reginald, Finucane, Francis, Veenendaal, Aletha, van Berkum, Frank, Johannsson-Vidarsdóttir, Solrun, Van de Walle, Vivienne, Meesters, Eelco, Hjelmesæth, Jøran, Klemsdal, Tor Ole, Kulseng, Bård, Bach-Kliegel, Birgit, Laederach, Kurt, Villiger, Lukas, Golay, Alain, Bilz, Stefan, Sathyapalan, Thozhukat, Bain, Stephen, Kumar, Sudesh, Le Roux, Carel Wynard, Lean, Michael E.J., McGowan, Barbara, Rehman, Tariq, Wilding, John, Wittert, Gary, Caterson, Ian, Proietto, Joeseph, Prins, John, Neto, Bruno Geloneze, Gross, Jorge Luiz, Chacra, Antonio Roberto, Halpern, Alfredo, de Almeida Suplicy, Henrique, Chow, Francis Chun Chung, Thacker, Hemant P, Chadha, Manoj, Chandalia, Hemaraj, Unnikrishnan, Ambika, Kalra, Sanjay, Deshpande, Neeta, Shunmugavelu, Minakshi, Deshmukh, Vaishali Chetan, Maislos, Maximo, Lieberman, Gabriella Segal, Shimon, Ilan, Stern, Naftali, Nabriski, Dan, Karnieli, Eddy, Shehadeh, Naim, Gonzalez-Galvez, Guillermo, del Rosario Arechavaleta-Granell, Maria, Ortiz, Rafael Margarito Violante, Franco, Guadalupe Morales, Gurieva, Irina, Suplotova, Lyudmila Aleksandrovna, Troshina, Ekaterina, Ruyatkina, Ludmila Aleksandrovna, Voychik, Emma Anatolievna, Martsevich, Sergey, Startseva, Maria A, Seeber, Mary Elizabeth, Badat, Aysha, Ellis, Graham, Altuntas, Yuksel, Guler, Serdar, Ulgen, Ender, Delibasi, Tuncay, Chetty, Tony, Hart, Randy, Janzen, Jeannette, Labonte, Isabelle, Lau, David, Liutkus, Joanne, O'Keefe, Dennis, Padwal, Raj, Ransom, Thomas P.P., Tytus, Richard, Weisnagel, Stanley John, Adler, Jay, Aqua, Keith, Aronoff, Stephen L, Bedel, Gary W., Blevins, Thomas Craig, Blumenau, Joe, Brockmyre, Andrew Peter, Call, Robert S, Canadas, Rafael, Chaykin, Louis B, Cohen, Kenneth, Conrow, Jeffrey Keith, Davis, Matthew G, Downey, H Jackson, Drosman, Steven Richard, Duckor, Steven, Farmer, H. Frank, Farrell, James, Fehnel, Stephen, Finneran, Matthew Patrick, Forbes, Ray, Forker, Alan, Fredrick, Mark, Fujioka, Ken, Geller, Steven Andrew, Gill, Santosh, Glaser, Linda, Greco, Susan Neims, Greenway, Frank Lyons, Harper, Wayne, Herman, Lee, Hoekstra, John, Ingebretsen, Richard, Ison, Rodney, Jain, Rajeev K, Kaplan, Roy, Kaster, Steven Richard, Haase, Gregory A, Kerzner, Boris, Kirstein, Judith Lee, Koltun, William, Krieger, Diane R, Lewis, Cora Elizabeth, Madder, Robert, Marple, Richard N, McDermott, Edward J, Mello, Curtis John, Miller, Alan B., Mullen, Julie, Nardandrea, John, O'Neil, Patrick, Pi-Sunyer, F. Xavier, Pucillo, Ronald M, Rhee, Chanhaeng, Redrick, Scott, Pardini, Aaron, Rothman, Jeffrey, Rubino, Domenica Marie, Sellers, Gladstone, Smith, Timothy, Byars, William David, Soufer, Joseph, Sussman, Allen Michael, Patrick, Kyle, Schramm, Erich Lloyd, Van Cleeff, Martin, Berg, Saul Reuel, Wyatt, Holly Roxanna, Simon, James Alan, le Roux, Carel W, Astrup, Arne, Greenway, Frank, Lau, David C W, Ortiz, Rafael Violante, Wilding, John P H, Skjøth, Trine V, Manning, Linda Shapiro, and Pi-Sunyer, Xavier

Published
2017
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19. The Effect of Interventions to Prevent Type 2 Diabetes on the Development of Diabetic Retinopathy: The DPP/DPPOS Experience

Author

White, Neil H., Pan, Qing, Knowler, William C., Schroeder, Emily B., Dabelea, Dana, Chew, Emily Y., Blodi, Barbara, Goldberg, Ronald B., Pi-Sunyer, Xavier, Darwin, Christine, Schlögl, Mathias, Nathan, David M., Goldstein, Barry J., Furlong, Kevin, Smith, Kellie A., Mendoza, Jewel, Wildman, Wendi, Simmons, Marsha, Jensen, Genine, Liberoni, Renee, Spandorfer, John, Pepe, Constance, Donahue, Richard P., Prineas, Ronald, Rowe, Patricia, Giannella, Anna, Calles, Jeanette, Sanguily, Juliet, Cassanova-Romero, Paul, Castillo-Florez, Sumaya, Florez, Hermes J., Garg, Rajesh, Kirby, Lascelles, Lara, Olga, Larreal, Carmen, McLymont, Valerie, Mendez, Jadell, Perry, Arlette, Saab, Patrice, Veciana, Bertha, Haffner, Steven M., Hazuda, Helen P., Montez, Maria G., Isaac, Juan, Hattaway, Kathy, Lorenzo, Carlos, Martinez, Arlene, Salazar, Monica, Walker, Tatiana, Hamman, Richard F., Nash, Patricia V., Steinke, Sheila C., Testaverde, Lisa, Truong, Jennifer, Anderson, Denise R., Ballonoff, Larry B., Bouffard, Alexis, Boxer, Rebecca S., Bucca, Brian, Calonge, B. Ned, Delve, Lynne, Farago, Martha, Hill, James O., Hoyer, Shelley R., Jenkins, Tonya, Jortberg, Bonnie T., Lenz, Dione, Miller, Marsha, Nilan, Thomas, Perreault, Leigh, Price, David W., Regensteiner, Judith G., Seagle, Helen, Smith, Carissa M., VanDorsten, Brent, Horton, Edward S., Munshi, Medha, Lawton, Kathleen E., Poirier, Catherine S., Swift, Kati, Jackson, Sharon D., Arky, Ronald A., Bryant, Marybeth, Burke, Jacqueline P., Caballero, Enrique, Callaphan, Karen M., Fargnoli, Barbara, Franklin, Therese, Ganda, Om P., Guidi, Ashley, Guido, Mathew, Jacobsen, Alan M., Kula, Lyn M., Kocal, Margaret, Lambert, Lori, Ledbury, Sarah, Malloy, Maureen A., Middelbeek, Roeland J.W., Nicosia, Maryanne, Oldmixon, Cathryn F., Pan, Jocelyn, Quitingon, Marizel, Rainville, Riley, Rubtchinsky, Stacy, Seely, Ellen W., Sansoucy, Jessica, Schweizer, Dana, Simonson, Donald, Smith, Fannie, Solomon, Caren G., Spellman, Jeanne, Warram, James, Kahn, Steven E., Montgomery, Brenda K., Fattaleh, Basma, Colegrove, Celeste, Fujimoto, Wilfred, Knopp, Robert H., Lipkin, Edward W., Marr, Michelle, Morgan-Taggart, Ivy, Murillo, Anne, O’Neal, Kayla, Trence, Dace, Taylor, Lonnese, Thomas, April, Tsai, Elaine C., Kitabchi, Abbas E., Dagogo-Jack, Samuel, Murphy, Mary E., Taylor, Laura, Dolgoff, Jennifer, Hampton, Ethel Faye, Applegate, William B., Bryer-Ash, Michael, Clark, Debra, Frieson, Sandra L., Ibebuogu, Uzoma, Imseis, Raed, Lambeth, Helen, Lichtermann, Lynne C., Oktaei, Hooman, Ricks, Harriet, Rutledge, Lily M.K., Sherman, Amy R., Smith, Clara M., Soberman, Judith E., Williamsleaves, Beverly, Patel, Avnisha, Nyenwe, Ebenezer A., Metzger, Boyd E., Molitch, Mark E., Wallia, Amisha, Johnson, Mariana K., VanderMolen, Sarah, Adelman, Daphne T., Behrends, Catherine, Cook, Michelle, Fitzgibbon, Marian, Giles, Mimi M., Hartmuller, Monica, Johnson, Cheryl K.H., Larsen, Diane, Lowe, Anne, Lyman, Megan, McPherson, David, Penn, Samsam C., Pitts, Thomas, Reinhart, Renee, Roston, Susan, Schinleber, Pamela A., McKitrick, Charles, Turgeon, Heather, Larkin, Mary, Mugford, Marielle, Thangthaeng, Nopporn, Leander, Fernelle, Abbott, Kathy, Anderson, Ellen, Bissett, Laurie, Bondi, Kristy, Cagliero, Enrico, Florez, Jose C., Delahanty, Linda, Goldman, Valerie, Grassa, Elaine, Gurry, Lindsey, D’Anna, Kali, Leandre, Fernelle, Lou, Peter, Poulos, Alexandra, Raymond, Elyse, Ripley, Valerie, Stevens, Christine, Tseng, Beverly, Olefsky, Jerrold M., Barrettonnor, Elizabeth, Mudaliar, Sunder, Rosario Araneta, Maria, Carrion-Petersen, Mary Lou, Vejvoda, Karen, Bassiouni, Sarah, Beltran, Madeline, Claravall, Lauren N., Dowden, Jonalle M., Edelman, Steven V., Garimella, Pranav, Henry, Robert R., Horne, Javiva, Lamkin, Marycie, Szerdi Janesch, Simona, Leos, Diana, Polonsky, William, Ruiz, Rosa, Smith, Jean, Torio-Hurley, Jennifer, Pi-Sunyer, F. Xavier, Laferrere, Blandine, Lee, Jane E., Hagamen, Susan, Kelly-Dinham, Kim, Allison, David B., Agharanya, Nnenna, Aronoff, Nancy J., Baldo, Maria, Crandall, Jill P., Foo, Sandra T., Luchsinger, Jose A., Pal, Carmen, Parkes, Kathy, Pena, Mary Beth, Roman, Julie, Rooney, Ellen S., VanWye, Gretchen E.H., Viscovich, Kristine A., Prince, Melvin J., Marrero, David G., Mather, Kieren J., De Groot, Mary, Kelly, Susie M., Jackson, Marcia A., McAtee, Gina, Putenney, Paula, Ackermann, Ronald T., Cantrell, Carolyn M., Dotson, Yolanda F., Fineberg, Edwin S., Fultz, Megan, Guare, John C., Hadden, Angela, Ignaut, James M., Kirkman, Marion S., O’Kelly Phillips, Erin, Pinner, Kisha L., Porter, Beverly D., Roach, Paris J., Rowland, Nancy D., Wheeler, Madelyn L., Ratner, Robert E., Aroda, Vanita, Magee, Michelle, Youssef, Gretchen, Shapiro, Sue, Andon, Natalie, Bavido-Arrage, Catherine, Boggs, Geraldine, Bronsord, Marjorie, Brown, Ernestine, Love Burkott, Holly, Cheatham, Wayman W., Cola, Susan, Evans, Cindy, Gibbs, Peggy, Kellum, Tracy, Leon, Lilia, Lagarda, Milvia, Levatan, Claresa, Lindsay, Milajurine, Nair, Asha K., Park, Jean, Passaro, Maureen, Silverman, Angela, Uwaifo, Gabriel, Wells-Thayer, Debra, Wiggins, Renee, Saad, Mohammed F., Watson, Karol, Budget, Maria, Jinagouda, Sujata, Botrous, Medhat, Sosa, Anthony, Tadros, Sameh, Akbar, Khan, Conzues, Claudia, Magpuri, Perpetua, Ngo, Kathy, Rassam, Amer, Waters, Debra, Xapthalamous, Kathy, Santiago, Julio V., Brown, Angela L., Santiago, Ana, Das, Samia, Khare-Ranade, Prajakta, Stich, Tamara, Fisher, Edwin, Hurt, Emma, Jones, Jackie, Jones, Tracy, Kerr, Michelle, McCowan, Sherri, Ryder, Lucy, Wernimont, Cormarie, Saudek, Christopher D., Hill Golden, Sherita, Bradley, Vanessa, Sullivan, Emily, Whittington, Tracy, Abbas, Caroline, Allen, Adrienne, Brancati, Frederick L., Cappelli, Sharon, Clark, Jeanne M., Charleston, Jeanne B., Freel, Janice, Horak, Katherine, Greene, Alicia, Jiggetts, Dawn, Johnson, Delois, Joseph, Hope, Kalyani, Rita, Loman, Kimberly, Mathioudakis, Nestoras, Maruthur, Nisa, Mosley, Henry, Reusing, John, Rubin, Richard R., Samuels, Alafia, Shields, Thomas, Stephens, Shawne, Stewart, Kerry J., Thomas, LeeLana, Utsey, Evonne, Williamson, Paula, Schade, David S., Adams, Karwyn S., Johannes, Carolyn, Hemphill, Claire, Hyde, Penny, Canady, Janene L., Atler, Leslie F., Boyle, Patrick J., Burge, Mark R., Chai, Lisa, Colleran, Kathleen, Fondino, Ateka, Gonzales, Ysela, Hernandez-McGinnis, Doris A., Katz, Patricia, King, Carolyn, Middendorf, Julia, Rubinchik, Sofya, Senter, Willette, Shamoon, Harry, Crandall, Jill, Brown, Janet O., Trandafirescu, Gilda, Powell, Danielle, Adorno, Elsie, Cox, Liane, Duffy, Helena, Engel, Samuel, Friedler, Allison, Goldstein, Angela, Howardentury, Crystal J., Lukin, Jennifer, Kloiber, Stacey, Longchamp, Nadege, Martinez, Helen, Pompi, Dorothy, Scheindlin, Jonathan, Tomuta, Norica, Violino, Elissa, Walker, Elizabeth A., Wylie-Rosett, Judith, Zimmerman, Elise, Zonszein, Joel, Wing, Rena R., Orchard, Trevor, Venditti, Elizabeth, Koenning, Gaye, Kramer, M. Kaye, Smith, Marie, Jeffries, Susan, Weinzierl, Valarie, Barr, Susan, Benchoff, Catherine, Boraz, Miriam, Clifford, Lisa, Culyba, Rebecca, Frazier, Marlene, Gilligan, Ryan, Guimond, Stephanie, Harrier, Susan, Harris, Louann, Kriska, Andrea, Manjoo, Qurashia, Mullen, Monica, Noel, Alicia, Otto, Amy, Pettigrew, Jessica, Rockette-Wagner, Bonny, Rubinstein, Debra, Semler, Linda, Smith, Cheryl F., Williams, Katherine V., Wilson, Tara, Arakaki, Richard F., Mau, Marjorie K., Latimer, Renee W., Isonaga, Mae K., Baker-Ladao, Narleen K., Bow, Ralph, Bermudez, Nina E., Dias, Lorna, Inouye, Jillian, Melish, John S., Mikami, Kathy, Mohideen, Pharis, Odom, Sharon K., Perry, Raynette U., Yamamoto, Robin E., Hanson, Robert L., Shah, Vallabh, Hoskin, Mary A., Percy, Carol A., Cooeyate, Norman, Natewa, Camille, Dodge, Charlotte, Enote, Alvera, Anderson, Harelda, Acton, Kelly J., Andre, Vickie L., Barber, Rosalyn, Begay, Shandiin, Bennett, Peter H., Benson, Mary Beth, Bird, Evelyn C., Broussard, Brenda A., Bucca, Brian C., Chavez, Marcella, Cook, Sherron, Curtis, Jeff, Dacawyma, Tara, Doughty, Matthew S., Duncan, Roberta, Edgerton, Cyndy, Ghahate, Jacqueline M., Glass, Justin, Glass, Martia, Gohdes, Dorothy, Grant, Wendy, Horse, Ellie, Ingraham, Louise E., Jackson, Merry, Jay, Priscilla, Kaskalla, Roylen S., Kavena, Karen, Kessler, David, Kobus, Kathleen M., Krakoff, Jonathan, Kurland, Jason, Manus, Catherine, McCabe, Cherie, Michaels, Sara, Morgan, Tina, Nashboo, Yolanda, Nelson, Julie A., Poirier, Steven, Polczynski, Evette, Piromalli, Christopher, Reidy, Mike, Roumain, Jeanine, Rowse, Debra, Roy, Robert J., Sangster, Sandra, Sewenemewa, Janet, Smart, Miranda, Spencer, Chelsea, Tonemah, Darryl, Williams, Rachel, Wilson, Charlton, Yazzie, Michelle, Bain, Raymond, Fowler, Sarah, Larsen, Michael D., Jablonski, Kathleen, Temprosa, Marinella, Brenneman, Tina, Edelstein, Sharon L., Abebe, Solome, Bamdad, Julie, Barkalow, Melanie, Bethepu, Joel, Bezabeh, Tsedenia, Bowers, Anna, Butler, Nicole, Callaghan, Jackie, Carter, Caitlin E., Christophi, Costas, Dwyer, Gregory M., Foulkes, Mary, Gao, Yuping, Gooding, Robert, Gottlieb, Adrienne, Grimes, Kristina L., Grover-Fairchild, Nisha, Haffner, Lori, Hoffman, Heather, Jones, Steve, Jones, Tara L., Katz, Richard, Kolinjivadi, Preethy, Lachin, John M., Ma, Yong, Mucik, Pamela, Orlosky, Robert, Reamer, Susan, Rochon, James, Sapozhnikova, Alla, Sherif, Hanna, Stimpson, Charlotte, Hogan Tjaden, Ashley, Walker-Murray, Fredricka, Venditti, Elizabeth M., Kriska, Andrea M., Weinzierl, Valerie, Marcovina, Santica, Aldrich, F. Alan, Harting, Jessica, Albers, John, Strylewicz, Greg, Killeen, Anthony, Gabrielson, Deanna, Eastman, R., Fradkin, Judith, Garfield, Sanford, Lee, Christine, Gregg, Edward, Zhang, Ping, O’Leary, Dan, Evans, Gregory, Budoff, Matthew, Dailing, Chris, Stamm, Elizabeth, Schwartz, Ann, Navy, Caroline, Palermo, Lisa, Rautaharju, Pentti, Prineas, Ronald J., Soliman, Elsayed Z., Alexander, Teresa, Campbell, Charles, Hall, Sharon, Li, Yabing, Mills, Margaret, Pemberton, Nancy, Rautaharju, Farida, Zhang, Zhuming, Hu, Julie, Hensley, Susan, Keasler, Lisa, Taylor, Tonya, Danis, Ronald, Davis, Matthew, Hubbard, Larry, Endres, Ryan, Elsas, Deborah, Johnson, Samantha, Myers, Dawn, Barrett, Nancy, Baumhauer, Heather, Benz, Wendy, Cohn, Holly, Corkery, Ellie, Dohm, Kristi, Domalpally, Amitha, Gama, Vonnie, Goulding, Anne, Ewen, Andy, Hurtenbach, Cynthia, Lawrence, Daniel, McDaniel, Kyle, Pak, Jeong, Reimers, James, Shaw, Ruth, Swift, Maria, Vargo, Pamela, Watson, Sheila, Manly, Jennifer, Mayer-Davis, Elizabeth, Moran, Robert R., Ganiats, Ted, David, Kristin, Sarkin, Andrew J., Groessl, Erik, Katzir, Naomi, Chong, Helen, Herman, William H., Brändle, Michael, Brown, Morton B., Altshuler, David, Billings, Liana K., Chen, Ling, Harden, Maegan, Pollin, Toni I., Shuldiner, Alan R., Franks, Paul W., and Hivert, Marie-France

Subjects
Advanced and Specialized Nursing, Endocrinology, Diabetes and Metabolism, Internal Medicine, Pathophysiology/Complications
Abstract

OBJECTIVE To determine whether interventions that slow or prevent the development of type 2 diabetes in those at risk reduce the subsequent prevalence of diabetic retinopathy. RESEARCH DESIGN AND METHODS The Diabetes Prevention Program (DPP) randomized subjects at risk for developing type 2 diabetes because of overweight/obesity and dysglycemia to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB) to assess the prevention of diabetes. During the DPP and DPP Outcome Study (DPPOS), we performed fundus photography over time on study participants, regardless of their diabetes status. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study grading system, with diabetic retinopathy defined as typical lesions of diabetic retinopathy (microaneurysms, exudates, or hemorrhage, or worse) in either eye. RESULTS Despite reduced progression to diabetes in the ILS and MET groups compared with PLB, there was no difference in the prevalence of diabetic retinopathy between treatment groups after 1, 5, 11, or 16 years of follow-up. No treatment group differences in retinopathy were found within prespecified subgroups (baseline age, sex, race/ethnicity, baseline BMI). In addition, there was no difference in the prevalence of diabetic retinopathy between those exposed to metformin and those not exposed to metformin, regardless of treatment group assignment. CONCLUSIONS Interventions that delay or prevent the onset of type 2 diabetes in overweight/obese subjects with dysglycemia who are at risk for diabetes do not reduce the development of diabetic retinopathy for up to 20 years.

Published
2022

22. Risk factors for the development of retinopathy in pre-diabetes and type 2 diabetes: The Diabetes Prevention Program experience

Author

White, Neil H, Pan, Qing, Knowler, William C, Schroeder, Emily B, Dabelea, Dana, Chew, Emily Y, Blodi, Barbara, Goldberg, Ronald B, Pi-Sunyer, Xavier, Darwin, Christine, Schlögl, Mathias, Nathan, David M, et al, and University of Zurich

Subjects
Advanced and Specialized Nursing, Diabetes and Metabolism, Endocrinology, 11221 Clinic for Geriatric Medicine, Internal Medicine, 610 Medicine & health
Abstract

OBJECTIVE: To determine glycemic and non-glycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time on adults at high risk to develop T2D, including after they developed diabetes. Fundus photographs were graded using the ETDRS grading system with DR defined as typical lesions of DR (microaneurysms, exudates or hemorrhage, or worse) in either eye. RESULTS: By DPPOS year 16 (approximately 20 years after randomization into DPP), 24% of 1,614 who had developed T2D and 14% of 885 who remained non-diabetic had DR. In univariate analyses, utilizing results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared to Non-Hispanic Whites (NHW), and higher HbA1c, fasting and 2-hour plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared to NHW (OR = 0.36; 95% CI: 0.20-0.66) and average HbA1c was associated with more DR (OR = 1.92; 95% CI: 1.46-1.74 per SD [0.7%] increase in HbA1c). CONCLUSION: DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D.

Published
2022

24. Risk factors for the development of retinopathy in pre-diabetes and type 2 diabetes: The Diabetes Prevention Program experience

Author

White, Neil H., primary, Pan, Qing, primary, Knowler, William C., primary, Schroeder, Emily B., primary, Dabelea, Dana, primary, Chew, Emily Y., primary, Blodi, Barbara, primary, Goldberg, Ronald B., primary, Pi-Sunyer, Xavier, primary, Darwin, Christine, primary, Schlögl, Mathias, primary, Nathan, David M., primary, and Group, the DPPOS Research, primary

Published
2022
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26. The Effect of Interventions to Prevent Type 2 Diabetes on the Development of Diabetic Retinopathy: The DPP/DPPOS Experience

Author

White, Neil H., primary, Pan, Qing, primary, Knowler, William C., primary, Schroeder, Emily B., primary, Dabelea, Dana, primary, Chew, Emily Y., primary, Blodi, Barbara, primary, Goldberg, Ronald B., primary, Pi-Sunyer, Xavier, primary, Darwin, Christine, primary, Schlögl, Mathias, primary, Nathan, David M., primary, and Group, the Diabetes Prevention Program Research, primary

Published
2022
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27. Weight Change During the Postintervention Follow-up of Look AHEAD

Author

Wing, Rena R., primary, Neiberg, Rebecca H., primary, Bahnson, Judy L., primary, Clark, Jeanne M., primary, Espeland, Mark A., primary, Hill, James O., primary, Johnson, Karen C., primary, Knowler, William C., primary, Olson, KayLoni, primary, Steinburg, Helmut, primary, Pi-Sunyer, Xavier, primary, Wadden, Thomas A., primary, Wyatt, Holly, primary, and Group, the Look AHEAD Research, primary

Published
2022
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28. Development and Validation of a Prediction Model for Infant Fat Mass

Author

Plows, Jasmine F., primary, Berger, Paige K., additional, Jones, Roshonda B., additional, Campbell, Elizabeth, additional, Leibovitch, Emily, additional, Alderete, Tanya L., additional, Horowitz, Michelle, additional, Pi-Sunyer, Xavier, additional, Gallagher, Dympna, additional, and Goran, Michael I., additional

Published
2022
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29. Additional file 1 of The 2018 World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) score and diabetes risk in the Diabetes Prevention Program Outcomes Study (DPPOS)

Author

Shams-White, Marissa M., Tjaden, Ashley H., Edelstein, Sharon L., Bassiouni, Sarah, Kahle, Lisa L., Kim, Catherine, Pi-Sunyer, Xavier, Temple, Karla A., Venditti, Elizabeth M., Reedy, Jill, and Heckman-Stoddard, Brandy M.

Abstract

Additional file 1. Supplemental Tables and Figures.

Published
2022
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31. Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

Author

Jakicic, John M., primary, Berkowitz, Robert I., primary, Bolin, Paula, primary, Bray, George A., primary, Clark, Jeanne M., primary, Coday, Mace, primary, Egan, Caitlin, primary, Evans, Mary, primary, Foreyt, John P., primary, Fulton, Janet E., primary, Greenway, Frank L., primary, Gregg, Edward W., primary, Hazuda, Helen P., primary, Hill, James O., primary, Horton, Edward S., primary, Hubbard, Van S., primary, Jeffery, Robert W., primary, Johnson, Karen C., primary, Johnson, Ruby, primary, Kahn, Steven E., primary, Kure, Anne, primary, Lang, Wei, primary, Lewis, Cora E., primary, Nathan, David M., primary, Patricio, Jennifer, primary, Peters, Anne, primary, Pi-Sunyer, Xavier, primary, Pownall, Henry, primary, Rejeski, W. Jack, primary, Safford, Monika, primary, Stewart, Kerry J., primary, Wadden, Thomas A., primary, Walkup, Michael P., primary, Wing, Rena R., primary, and Wyatt, Holly, primary

Published
2022
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34. Adiposity, related biomarkers, and type 2 diabetes after gestational diabetes: The Diabetes Prevention Program

Author

Wander, Pandora L., primary, Christophi, Costas A., additional, Araneta, Maria Rosario G., additional, Boyko, Edward J., additional, Enquobahrie, Daniel A., additional, Dabelea, Dana, additional, Goldberg, Ronald B., additional, Kahn, Steven E., additional, Kim, Catherine, additional, Pi‐Sunyer, Xavier, additional, and Knowler, William C., additional

Published
2021
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35. Effect of Metformin and Lifestyle Interventions on Mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study

Author

Lee, Christine G., primary, Heckman-Stoddard, Brandy, primary, Dabelea, Dana, primary, Gadde, Kishore M., primary, Ehrmann, David, primary, Ford, Leslie, primary, Prorok, Philip, primary, Boyko, Edward J., primary, Pi-Sunyer, Xavier, primary, Wallia, Amisha, primary, Knowler, William C., primary, Crandall, Jill P., primary, Temprosa, Marinella, primary, and Group, the Diabetes Prevention Program Research, primary

Published
2021
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36. Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience.

Author

White, Neil H., Pan, Qing, Knowler, William C., Schroeder, Emily B., Dabelea, Dana, Chew, Emily Y., Blodi, Barbara, Goldberg, Ronald B., Pi-Sunyer, Xavier, Darwin, Christine, Schlögl, Mathias, Nathan, David M., Diabetes Prevention Program Outcome Study (DPPOS) Research Group:, Bray, George A., Gadde, Kishore M., Culbert, Iris W., Arceneaux, Jennifer, Chatellier, Annie, Dragg, Amber, and Champagne, Catherine M.

Subjects
TYPE 2 diabetes, DIABETIC retinopathy, PREDIABETIC state, DIABETES, GLUCOSE tolerance tests, RACE
Abstract

Objective: To determine glycemic and nonglycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D).Research Design and Methods: During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time in adults at high risk for developing T2D, including after they developed diabetes. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye.Results: By DPPOS year 16 (∼20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20-0.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46-1.74 per SD [0.7%] increase in HbA1c).Conclusions: DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D. [ABSTRACT FROM AUTHOR]

Published
2022
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39. Anthropometric models to estimate fat mass at 3 days, 15 and 54 weeks

Author

Gopalakrishnamoorthy, Mahalakshmi, primary, Whyte, Kathryn, additional, Horowitz, Michelle, additional, Widen, Elizabeth, additional, Toro‐Ramos, Tatiana, additional, Johnson, Jill, additional, Gidwani, Sonia, additional, Paley, Charles, additional, Rosenn, Barak, additional, Lin, Susan, additional, Thornton, John, additional, Pi‐Sunyer, Xavier, additional, and Gallagher, Dympna, additional

Published
2021
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42. Associations of Intensive Lifestyle Intervention in Type 2 Diabetes With Health Care Use, Spending, and Disability

Author

Huckfeldt, Peter J., Frenier, Chris, Pajewski, Nicholas M., Espeland, Mark, Peters, Anne, Casanova, Ramon, Pi-Sunyer, Xavier, Cheskin, Lawrence, and Goldman, Dana P.

Subjects
Counseling, Male, Medicare Part D, Eligibility Determination, Medicare, Disability Evaluation, Behavior Therapy, Humans, Life Style, Original Investigation, Aged, Glycated Hemoglobin, Research, Body Weight, Health Care Costs, Health Services, Middle Aged, United States, Exercise Therapy, Hospitalization, Online Only, Diabetes and Endocrinology, Diabetes Mellitus, Type 2, Female, Medicare Part B, Medicare Part A, Health Expenditures, Emergency Service, Hospital, Diet Therapy
Abstract

Key Points Question Is an intensive lifestyle intervention for type 2 diabetes associated with long-term health care use and Medicare spending? Findings This ancillary study of a randomized clinical trial linked 2796 participants with type 2 diabetes in a randomized intensive lifestyle intervention with Medicare data. Among linked participants, the intervention was associated with reduced weight, improved diabetes control, and reduced health care costs during the intervention, but there was no reduction in total health care spending after the intervention. Meaning These findings suggest that intensive lifestyle interventions targeted to patients with type 2 diabetes may need to be sustained to reduce long-term health care spending., This ancillary study of a randomized clinical trial examines the long-term associations of an intensive lifestyle intervention for type 2 diabetes with health care use, spending, and disability., Importance Intensive lifestyle interventions focused on diet and exercise can reduce weight and improve diabetes management. However, the long-term effects on health care use and spending are unclear, especially for public payers. Objective To estimate the association of effective intensive lifestyle intervention for weight loss with long-term health care use and Medicare spending. Design, Setting, and Participants This ancillary study used data from the Look AHEAD randomized clinical trial, which randomized participants with type 2 diabetes to an intensive lifestyle intervention or control group (ie, diabetes support and education), provided ongoing intervention from 2001 to 2012, and demonstrated improved diabetes management and reduced health care costs during the intervention. This study compared Medicare data between study arms from 2012 to 2015 to determine whether the intervention was associated with persistent reductions in health care spending. Exposure Starting in 2001, Look AHEAD’s intervention group participated in sessions with lifestyle counselors, dieticians, exercise specialists, and behavioral therapists with the goal of reducing weight 7% in the first year. Sessions occurred weekly in the first 6 months of the intervention and decreased over the intervention period. The controls participated in periodic group education sessions that occurred 3 times per year in the first year and decreased to 1 time per year later in the trial. Main Outcomes and Measures Outcomes included total Medicare spending, Part D prescription drug costs, Part A and Part B Medicare spending, hospital admissions, emergency department visits, and disability-related Medicare eligibility. Results This study matched Medicare administrative records for 2796 Look AHEAD study participants (54% of 5145 participants initially randomized and 86% of 3246 participants consenting to linkages). Linked intervention and control participants were of a similar age (mean [SD] age, 59.6 [5.4] years vs 59.6 [5.5] years at randomization) and sex (818 [58.1%] women vs 822 [59.3%] women). There was no statistically significant difference in total Medicare spending between groups (difference, −$133 [95% CI, −$1946 to $1681]; P = .89). In the intervention group, compared with the control group, there was statistically significantly higher Part B spending (difference, $513 [95% CI, $70 to $955]; P = .02) but lower prescription drug costs (difference, −$803 [95% CI, −$1522 to −$83]; P = .03). Conclusions and Relevance This ancillary study of a randomized clinical trial found that reductions in health care use and spending associated with an intensive lifestyle intervention for type 2 diabetes diminished as participants aged. Intensive lifestyle interventions may need to be sustained to reduce long-term health care spending. Trial Registration ClinicalTrials.gov Identifier: NCT03952728

Published
2020

45. Impact of an Intensive Lifestyle Intervention on Use and Cost of Medical Services Among Overweight and Obese Adults With Type 2 Diabetes: The Action for Health in Diabetes

Author

Espeland, Mark A., Glick, Henry A., Bertoni, Alain, Brancati, Frederick L., Bray, George A., Clark, Jeanne M., Curtis, Jeffrey M., Egan, Caitlin, Evans, Mary, Foreyt, John P., Ghazarian, Siran, Gregg, Edward W., Hazuda, Helen P., Hill, James O., Hire, Don, Horton, Edward S., Hubbard, Van S., Jakicic, John M., Jeffery, Robert W., Johnson, Karen C., Kahn, Steven E., Killean, Tina, Kitabchi, Abbas E., Knowler, William C., Kriska, Andrea, Lewis, Cora E., Miller, Marsha, Montez, Maria G., Murillo, Anne, Nathan, David M., Nyenwe, Ebenezer, Patricio, Jennifer, Peters, Anne L., Pi-Sunyer, Xavier, Pownall, Henry, Redmon, J. Bruce, Rushing, Julia, Ryan, Donna H., Safford, Monika, Tsai, Adam G., Wadden, Thomas A., Wing, Rena R., Yanovski, Susan Z., and Zhang, Ping

Published
2014
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48. Predictive utilities of lipid traits, lipoprotein subfractions and other risk factors for incident diabetes: a machine learning approach in the Diabetes Prevention Program

Author

Varga, Tibor V, primary, Liu, Jinxi, additional, Goldberg, Ronald B, additional, Chen, Guannan, additional, Dagogo-Jack, Samuel, additional, Lorenzo, Carlos, additional, Mather, Kieren J, additional, Pi-Sunyer, Xavier, additional, Brunak, Søren, additional, and Temprosa, Marinella, additional

Published
2021
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50. Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients. RIO-North

Author

Pi-Sunyer, Xavier F., Aronne, Louis J., Heshmati, Hassan M., Rosenstock, Julio, and Devin, Jeanne

Subjects
Obesity -- Care and treatment, Overweight persons -- Health aspects, Weight reducing preparations -- Dosage and administration
Abstract

The efficacy and safety of rimonabant is compared with placebo each in conjunction with diet and exercise for sustained changes in weight and cardiometabolic risk factors over two years. The results suggest that 20 mg/d of rimonabant is effective in reducing body weight and waist circumference, while also favorably affecting several cardiometabolic risk factors.

Published
2006

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