I have to say, I have a rather dismal view of the Diabetes Prevention Program (DPP). I think it was ill-conceived to begin with and used a totally wacked approach. The DPP defined an end point that measure how many people with pre-diabetes (which is just diabetes) progressed to full blown diabetes (which is worse diabetes). It measured how many people with diabetes “got worse.” So if you didn’t get worse you “prevented” diabetes. How stupid is that? And the lifestyle treatment? Eat a high carb, low fat calorie restricted diet. I won’t say anything more than that.
So even though the DPP was messed up in design, how well did it work? The recently published follow up (after 15 years) study called the DPPOS found that
At year 15, the cumulative incidences of diabetes were 55% in the lifestyle group, 56% in the metformin group, and 62% in the placebo group.
So let’s make two observations. First, the majority of participants still progressed to diabetes. THEY DIDN"T PREVENT DIABETES! Second, the high carb low fat diet with exercise approach was USELESS! It was no better than just taking a metformin pill. And those patients that did the DPP, on 7% of those saw any benefit at all. Only one in 14 people would see any benefit in delaying their progression of diabetes.
Concluding that the DPP “proved” that diabetes is caused by poor lifestyle is just WRONG! How can one possibly conclude that?
And finally, the bone headed idea that a low fat diet would be “heart healthy” was also found to be a failure.
So I have to ask the question. What good is a public service message to inform people about pre-diabetes when we LIE TO THEM and then tell them they can prevent their diabetes. I have no issue with educating the public about diabetes but I object to lying because I believe it leads to harm (potentially serious harm).