Lifestyle modification (LSM) and medications (weight loss and insulin-sensitizing agents) successfully reduce diabetes incidence in adults at risk for diabetes; however, medication effects are short lived while LSM effects are better in the long term but decline with time. This according to a systematic review and meta-analysis that estimated aggregate long-term effects of different diabetes prevention strategies on diabetes incidence in adults aged ≥18 years at risk for diabetes. LSM and medication interventions (>6 months) were evaluated. Researchers found:

• 43 studies were included and pooled in meta-analysis (49,029 participants; mean age 57.3 years); 19 tested medications; 19 evaluated LSM, and 5 tested combined medications and LSM.
• At the end of the active intervention (range, 0.5-6.3 years), LSM was associated with relative risk (RR) reduction of 39% (RR, 0.61) and medications were associated with the RR reduction of 36% (RR, 0.64).
• Effects of medications were not sustained after they were discontinued; effects of LSM, however, were sustained after intervention was stopped, although the effects declined over time. At the end of the washout or follow-up periods, LSM studies (mean follow-up, 7.2 years) achieved an RR reduction of 28% (RR, 0.72;) while medication studies (mean follow-up, 17 weeks) showed no sustained RR reduction (RR, 0.95).