Long-Term Study Finds Lifestyle Intervention Reduces Risk of Multiple Chronic Diseases in Adults with Prediabetes

June 15, 2026 · Baton Rouge, LA

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New findings show lifestyle changes were linked to lower multimorbidity risk over 21 years

A major long-term study of adults with prediabetes found that intensive lifestyle intervention significantly reduced the risk of developing multiple chronic health conditions over time, highlighting the lasting benefits of healthy behavior changes for aging populations.

The study, “Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults with Prediabetes,” followed participants from the landmark Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS) for more than two decades. Participants, who were originally recruited between 1996 and 1999 because they were at high risk for type 2 diabetes, were randomized to one of three groups: intensive lifestyle intervention, metformin treatment or placebo.

Researchers found that participants treated with a structured lifestyle intervention between 1996-1999 had a 21% lower risk of developing multimorbidity – defined as having two or more chronic conditions – compared with those assigned to placebo over the next 20 years. The lifestyle intervention focused on weight loss through healthier eating and increased physical activity, with goals of reducing dietary fat, achieving at least 150 minutes of physical activity per week and losing at least 7% of body weight.

By contrast, participants assigned to metformin did not experience a statistically significant reduction in multimorbidity risk.

The observational follow-up study analyzed Medicare claims data through 2021 from 1,173 DPP participants enrolled across 27 U.S. clinical sites.

“Preventing diabetes is critically important, but preventing the accumulation of multiple chronic diseases as people age may have even broader implications for quality of life, independence and healthcare costs,” said lead author Marcel Salive.

Key findings include:

• Participants in the lifestyle intervention group had a significantly lower risk of developing two or more chronic conditions compared with the placebo group.
• The reduced risk remained even when diabetes was excluded from the definition of multimorbidity.
• Lifestyle intervention participants also had lower rates of costly disease combinations, including conditions involving stroke, chronic kidney disease, heart failure and COPD.
• Overall, 85% of participants developed at least two chronic conditions during follow-up, underscoring the widespread burden of multimorbidity among older adults.

The study examined 15 chronic conditions commonly tracked in Medicare data, including hypertension, heart disease, stroke, arthritis, chronic kidney disease, COPD, cancer, depression, dementia, osteoporosis and diabetes. Researchers say the findings add to growing evidence that sustained lifestyle modification can improve healthy aging and potentially reduce long-term healthcare burden.

The DPP is one of the most influential diabetes prevention studies ever conducted and has previously demonstrated that lifestyle intervention is highly effective at delaying or preventing type 2 diabetes. This latest analysis expands those findings by showing broader impacts on aging and chronic disease accumulation over time.

The DPP/DPPOS site at Pennington Biomedical Research Center currently follows 73 participants who have been with the study for nearly 30 years.

“Since Pennington Biomedical’s Dr. George Bray began studying these participants in 1996, the Diabetes Prevention Program has shown just how powerfully this treatment approach reduces the risk of developing diabetes,” said Dr. Owen Carmichael, Director of Biomedical Imaging and James W. and Neil Ann Parks Professor for Dementia Research, Prevention and Treatment at Pennington Biomedical. “What has become even more remarkable over time is seeing the ripple effect on overall health, with benefits extending far beyond diabetes to lowering the risk of heart disease, cancer and other chronic conditions. These Louisiana participants have helped shape not only diabetes care but modern medicine worldwide.”

The findings from the “Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults with Prediabetes” study were published in JAMA.