Losing weight and taking insulin-sensitizing medication reduces diabetes incidence, according to a meta-analysis of 43 studies involving nearly 50,000 individuals. Lifestyle modification was sustained for several years, whereas medication’s effects did not last as long, 19 of the studies looked at lifestyle management; 19 evaluated medications; and 5 tested combined medications and lifestyle management. Participants’ average age was ~57 years. Among the findings:

• Lifestyle management led to a relative risk reduction of 39%.
• Medication resulted in a relative risk reduction of 36%.
• The observed risk differences for lifestyle management and medication studies was 4 cases/100 person-years (a number-needed-to-treat of 25).
• After washout or follow-up periods, lifestyle management studies achieved a relative risk reduction of 28%; medication studies did not show sustained relative risk reduction.