The research used data from the Diabetes Prevention Program (DPP), a randomized clinical trial that enrolled 3,234 adults at high risk of diabetes across 27 U.S. sites starting in 1996. Participants were split into three groups: one followed an intensive lifestyle program, one took metformin, and one received a placebo. They were then followed for more than two decades through the DPP Outcomes Study (DPPOS), an observational follow-up that tracked long-term health outcomes through 2021.
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