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Long-term metformin adherence in the Diabetes Prevention Program Outcomes Study.
Elizabeth Arquin Walker1, Jeffrey S Gonzalez1,2, Mark T Tripputi3
1Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
BMJ Open Diabetes Research & Care
|October 7, 2020
Summary
Long-term metformin adherence in the Diabetes Prevention Program Outcomes Study (DPPOS) was predicted by early adherence and strategies to improve it. Higher metformin adherence was linked to reduced type 2 diabetes incidence.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Clinical Trials
Background:
- The Diabetes Prevention Program Outcomes Study (DPPOS) followed participants for over 11 years.
- Metformin was offered to participants in the original Diabetes Prevention Program (DPP) metformin group.
- Long-term adherence to metformin is crucial for diabetes prevention.
Purpose of the Study:
- To identify predictors of long-term adherence to metformin in the DPPOS.
- To determine if metformin adherence was associated with the incidence of type 2 diabetes.
Main Methods:
- An open-label continuation of the DPP randomized trial.
- Semiannual adherence interviews and pill counts assessed metformin use.
- Multivariate regression and Cox proportional hazards models analyzed adherence predictors and diabetes risk.
Main Results:
- 76% of eligible participants took metformin, with 478 reporting adherence issues.
- Higher adherence (≥80%) linked to early adherence in DPP and lower depression scores.
- Metformin adherence was significantly associated with a lower risk of developing type 2 diabetes.
Conclusions:
- Early metformin adherence and adherence strategies predict long-term adherence over 11 years.
- Higher adherence to metformin is associated with reduced type 2 diabetes incidence.
- Strategies to promote adherence at prescription and over time are recommended.
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