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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1470035
This article is part of the Research Topic Analyses on Health Status and Care Needs among Older Adults View all 29 articles

Long-term Impact of Diabetes Prevention Program Interventions on Walking Endurance

Provisionally accepted
Medha N Munshi Medha N Munshi 1,2Elizabeth Venditti Elizabeth Venditti 3Ashley Tjaden Ashley Tjaden 4William C Knowler William C Knowler 5Edward J Boyko Edward J Boyko 6Roeland Middelbeek Roeland Middelbeek 1Jose Alejandro Luchsinger Jose Alejandro Luchsinger 7Christine G Lee Christine G Lee 8Helen P Hazuda Helen P Hazuda 9Marcel E Salive Marcel E Salive 10Sharon L Edelstein Sharon L Edelstein 4Thomas W Storer Thomas W Storer 11,2DPP Research Group DPP Research Group 4*
  • 1 Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, United States
  • 2 Harvard Medical School, Boston, Massachusetts, United States
  • 3 Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • 4 Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, Maryland, United States
  • 5 Consultant, Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, Maryland, United States
  • 6 VA Puget Sound Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, Seattle, Washington, United States
  • 7 Columbia University Irving Medical Center, Columbia University, New York, New York, United States
  • 8 National Institute of Diabetes and Digestive and Kidney Diseases (NIH), Bethesda, Maryland, United States
  • 9 The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
  • 10 Division of Geriatrics and Clinical Gerontology, National Institute on Aging (NIH), Bethesda, Maryland, United States
  • 11 Brigham and Women's Hospital, Boston, United States

The final, formatted version of the article will be published soon.

    Objectives: Type 2 diabetes (T2D) and prediabetes are associated with poor walking endurance, a marker of physical function. We aimed to examine the long-term effects of metformin or intensive lifestyle intervention in adults at high risk of T2D on their 6minute walk test (6MWT) performance.Methods: Participants were randomized in the 3y DPP to lifestyle, metformin, or placebo, and subsequently followed in the DPP Outcomes Study. A 6MWT was conducted 20y after randomization. Associations between DPP interventions and 6MWT completion (achieving a distance ≥200m) were assessed using logistic regression. Among test completers, differences in distance walked (6MWD) were evaluated using multivariable linear regression. Additional variables of interest included concomitant measures of BMI and grip strength along with mean measures of HbA1c and self-reported physical activity.Results: Data on 1830 participants were analyzed. The interventions were neither associated with test completion, nor 6MWD among test completers (362, 364 and 360 m in the lifestyle, metformin, and placebo groups respectively, p=0.8). Age, education, grip strength, and PA were each significantly associated with the 6MWT completion and 6MWD after adjustment. Grip strength, PA, and education were positively associated with 6MWD, while age, BMI and HbA1c were negatively associated with 6MWDWe confirmed that the 6MWT is related to other measures of physical ability such as PA and grip strength in persons at-risk for and with T2D, suggesting potential long-term benefits of maintaining a healthy lifestyle. However, we did not observe a sustained effect of the original randomized interventions.

    Keywords: diabetes, Walking endurance, Aging, Six-minute walk test, lifestyle

    Received: 24 Jul 2024; Accepted: 27 Nov 2024.

    Copyright: © 2024 Munshi, Venditti, Tjaden, Knowler, Boyko, Middelbeek, Luchsinger, Lee, Hazuda, Salive, Edelstein, Storer and Research Group. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: DPP Research Group, Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, 20852-3943, Maryland, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.