Design
Multicenter randomized controlled trial
Evidence chain
Population
3,234 adults without diabetes who had elevated fasting and post-load glucose.
Intervention and comparator
Intensive lifestyle intervention, metformin, or placebo; mean follow-up 2.8 years.
Endpoint
Incidence of type 2 diabetes.
Reported result
Diabetes incidence was reduced by 58% with lifestyle intervention and 31% with metformin versus placebo.
Leptox interpretation
Landmark prevention evidence in a high-risk population; the primary result is diabetes incidence, not a modern obesity-pharmacotherapy weight endpoint.