Long-term impact of Diabetes Prevention Program interventions on walking endurance

Area of Science:

• Endocrinology
• Metabolic Diseases
• Gerontology

Background:

• Type 2 diabetes (T2D) and prediabetes are linked to reduced physical function, specifically poor walking endurance.
• The 6-minute walk test (6MWT) is a key indicator of physical function and endurance.

Purpose of the Study:

• To evaluate the 20-year impact of metformin versus intensive lifestyle intervention on 6-minute walk test (6MWT) performance in adults at high risk for T2D.
• To assess the long-term effects of the Diabetes Prevention Program (DPP) interventions on walking endurance.

Main Methods:

• 1830 participants from the DPP randomized trial (lifestyle, metformin, placebo) were followed for 20 years.
• The 6-minute walk test (6MWT) was used to measure walking endurance, assessing both completion and distance.
• Logistic and multivariable linear regression analyses examined associations between interventions, 6MWT outcomes, and other health metrics like BMI, grip strength, HbA1c, and physical activity (PA).

Main Results:

• No significant differences in 6MWT completion or distance walked were observed between the lifestyle, metformin, and placebo groups after 20 years.
• Age, education, grip strength, and physical activity (PA) were significantly associated with 6MWT completion and distance.
• Positive associations were found between grip strength, PA, education, and 6MWD; negative associations were observed with age, BMI, and HbA1c.

Conclusions:

• While the original DPP interventions did not show sustained effects on walking endurance after 20 years, the study reinforces the link between physical ability measures (PA, grip strength) and 6MWT performance in individuals at risk for or with T2D.
• Maintaining a healthy lifestyle appears to have potential long-term benefits for physical function, even if not directly attributable to the initial randomized intervention.