Lee CG, Heckman-Stoddard B, Dabelea D, et al. - In adults carrying high risk for type 2 diabetes, the main cause of mortality was cancer. Diabetes was averted with the help of metformin and lifestyle modification but neither strategy decreased all-cause, cancer, or cardiovascular mortality rates.

• A total of 3,234 adults at high risk for type 2 diabetes were included in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.

• They were randomized to an intensive lifestyle intervention, masked metformin, or placebo.

• Mortality from all causes, cancer, or cardiovascular disease remained unaffected by metformin vs placebo, with hazard ratios (HRs) 0.99, 1.04, 1.08, respectively.

• Lifestyle modification also showed no influence on all-cause (HR 1.02), cancer (HR 1.07), or cardiovascular disease (HR 1.18) mortality.