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Incidence of Type 2 Diabetes in the Randomized Multiple Risk Factor Intervention Trial

George Davey Smith, DSc; Yiscah Bracha, MS; Kenneth H. Svendsen, MS; James D. Neaton, PhD; Steven M. Haffner, MD; Lewis H. Kuller, MD, Multiple Risk Factor Intervention Trial Research Group*
[+] Article and Author Information

From the University of Bristol, Bristol, United Kingdom; Minneapolis Medical Research Foundation and University of Minnesota, Minneapolis, Minnesota; The University of Texas Health Science Center at San Antonio, San Antonio, Texas; and the University of Pittsburgh, Pittsburgh, Pennsylvania.


This trial is registered as NCT00000487 on http://clinicaltrials.gov.

Acknowledgments: The authors acknowledge the efforts of the many MRFIT investigators who collected these data and the MRFIT Editorial Committee (Jerome D. Cohen, MD; Jeffrey A. Cutler, MD; Richard Grimm Jr., MD, PhD; Lewis H. Kuller, MD, DPH; James D. Neaton, PhD; Judith K. Ockene, PhD; Ronald Prineas, MD, PhD; and Jeremiah Stamler, MD). The authors thank Dr. Johan Eriksson for information about the percentage of participants who were smokers at baseline in the Finnish intervention study (9).

Grant Support: By National Heart, Lung, and Blood Institute grant R01-HL68140.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: George Davey Smith, DSc, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, United Kingdom; e-mail, zetkin@bristol.ac.uk.

Current Author Addresses: Dr. Davey Smith: Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, United Kingdom.

Ms. Bracha: Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, 825 South Eighth Street, Suite 440, Minneapolis, MN 55404.

Mr. Svendsen and Dr. Neaton: Coordinating Centers for Biometric Research, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455.

Dr. Haffner: Division of Clinical Epidemiology, Department of Medicine, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7873.

Dr. Kuller: The Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261.

Author Contributions: Conception and design: G. Davey Smith, Y. Bracha, J.D. Neaton.

Analysis and interpretation of the data: G. Davey Smith, Y. Bracha, K.H. Svendsen, J.D. Neaton, L.H. Kuller.

Drafting of the article: G. Davey Smith, Y. Bracha, J.D. Neaton.

Critical revision of the article for important intellectual content: G. Davey Smith, K.H. Svendsen, J.D. Neaton, L.H. Kuller.

Final approval of the article: G. Davey Smith, Y. Bracha, J.D. Neaton, L.H. Kuller.

Statistical expertise: Y. Bracha, K.H. Svendsen, J.D. Neaton.

Obtaining of funding: J.D. Neaton.

Collection and assembly of data: J.D. Neaton.


Ann Intern Med. 2005;142(5):313-322. doi:10.7326/0003-4819-142-5-200503010-00006
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Among nonsmokers at baseline in the MRFIT, the intervention program was associated with an 18% reduction in the incidence of diabetes over a 6-year follow-up period compared with those randomly assigned to usual care. Among smokers at baseline, however, the special intervention group had a 26% greater risk for diabetes than the usual care group. The relative differences in diabetes incidence between the special intervention and usual care group are significantly different for baseline smokers and nonsmokers (P = 0.0003). Since such an interaction was not postulated at the time our investigation began, it should be interpreted cautiously (26).

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Summary for Patients

Development of Type 2 Diabetes among People Participating in a Program To Promote Healthy Behaviors

The summary below is from the full report titled “Incidence of Type 2 Diabetes in the Randomized Multiple Risk Factor Intervention Trial.” It is in the 1 March 2005 issue of Annals of Internal Medicine (volume 142, pages 313-322). The authors are G. Davey Smith, Y. Bracha, K.H. Svendsen, J.D. Neaton, S.M. Haffner, and L.H. Kuller, for the Multiple Risk Factor Intervention Trial Research Group.

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