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Updated: Feb 4, 2026

Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Estimated Optimal Individualized Diabetes Risk Prediction From Preventive Interventions in the U.S. General
Jeanette M Stafford1, Byron Jaeger1, Ramon Casanova1
1Wake Forest University School of Medicine, Winston-Salem, NC.
Objective:
To calculate 3-year predicted risk for diabetes with a model including individualized preventive intervention effects for metformin therapy and intensive lifestyle among U.S. adults with prediabetes.
Research Design And Methods:
We included 2,778 participants with prediabetes from the National Health and Nutrition Examination Survey (NHANES) cycles 2015-2020. Using a validated type 2 diabetes risk prediction model, we calculated predicted risk and summarized the optimal prevention strategy (lowest predicted risk).
Results:
Mean predicted risk in this sample was 18.4% (95% CI 17.6, 19.3) for standard lifestyle recommendations (placebo), 14.4% (95% CI 13.9, 14.8) for metformin, 8.0% (95% CI 7.6, 8.4) for intensive lifestyle, and 7.6% (95% CI 7.2, 7.9) for participants' respective optimal intervention. The optimal intervention strategy was intensive lifestyle for 91% of the analytic sample.
Conclusions:
We demonstrate the potential population health benefits for diabetes prevention with use of a clinical decision tool, a diabetes risk prediction model with individualized preventive intervention effects.
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