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Lung function after randomization to metformin, lifestyle intervention or placebo in the Diabetes Prevention Program
Carrie L Pistenmaa1, Lindsay Doherty2, Emilia A Hermann3
1Department of Medicine, Columbia University Medical Center, New York, NY, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Respiratory Medicine
|August 4, 2026
Summary
Metformin and lifestyle interventions, previously studied for diabetes prevention, did not show long-term benefits for lung function or respiratory symptoms in adults at risk for diabetes.
Area of Science:
- Pulmonology
- Endocrinology
- Clinical Trials
Background:
- Metformin and lifestyle interventions are hypothesized to benefit chronic lung diseases.
- No prior randomized trials have investigated these interventions for lung health.
Purpose of the Study:
- To determine the long-term effects of metformin and lifestyle intervention on lung function.
- To assess the impact of these interventions on respiratory symptoms in individuals at risk for diabetes.
Main Methods:
- Utilized data from the Diabetes Prevention Program (DPP) and its Outcomes Study.
- Compared lung function (FEV1, FVC, FEV1/FVC) and respiratory symptoms (CAT score) via intention-to-treat analysis.
- Analyzed spirometry data approximately 19-22 years post-randomization.
Main Results:
- No significant association was found between randomization to metformin or lifestyle intervention and lung function measures (FEV1, FVC, FEV1/FVC).
- Rates of airflow obstruction, restrictive lung patterns, preserved ratio impaired spirometry (PRISm), and respiratory symptoms did not differ by randomization group.
- The study included 1,888 participants with a mean follow-up of 19 years.
Conclusions:
- Randomization to metformin or lifestyle intervention did not demonstrate significant long-term associations with improved lung function.
- These interventions did not appear to impact respiratory symptoms or spirometric abnormalities in the long term.
- Further research may be needed to explore other potential benefits or different interventions for chronic lung disease.
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