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Evidence found and GRADE certainty

257 questions · 270 findings · 42 reviews · Headline outcomes only

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No studies found 75 · 27.8%GRADE not reported 7 · 2.6%Very low 95 · 35.2%Low 50 · 18.5%Moderate 40 · 14.8%High 3 · 1.1%

Metformin vs diet and exercise or another antidiabetic drug

Placebo or diet and exercise Diagnostic criteria: 3 trials applied the WHO 1985 criteria (FPG <7.8 mmol/L and 2‐hour glucose ≥7.8 mmol/L and <11.1 mmol/L after a 75 g OGTT) (Fang 2004; Li 1999; Lu 2002). 5 trials applied the WHO 1999 criteria (FPG... · people at increased risk for developing type 2 diabetes

Summary of findings table for metformin probably leads to lower placebo or diet and exercise Diagnostic criteria: 3 trials applied… compared with diet and exercise or another antidiabetic drug (moderate certainty).

1 finding from 1 review

Metformin vs diet and exercise or another antidiabetic drug

Intensive diet plus exercise Diagnostic criteria: 1 trial applied the WHO 1985 criteria (FPG < 7.8 mmol/L and 2‐hour glucose ≥ 7.8 mmol/L and < 11.1 mmol/L) (Fang 2004) · people at increased risk for developing type 2 diabetes

Summary of findings table for metformin showed no clear difference in intensive diet plus exercise Diagnostic criteria: 1 trial applied… compared with diet and exercise or another antidiabetic drug (moderate certainty).

1 finding from 1 review

Metformin vs diet and exercise or another antidiabetic drug

Acarbose Diagnostic criteria: 1 trial applied the WHO 1985 criteria (FPG < 7.8 mmol/L and 2‐hour glucose ≥ 7.8 mmol/L and < 11.1 mmol/L) (Fang 2004). 1 trial applied the WHO 1999 criteria (FPG ≥ 7.0 mmol/L and/or a 2‐hpur glucose ≥ 11.1 mmol/L aft... · people at increased risk for developing type 2 diabetes

Summary of findings table for metformin showed no clear difference in acarbose Diagnostic criteria: 1 trial applied the WHO 1985 criteria… compared with diet and exercise or another antidiabetic drug (low certainty).

1 finding from 1 review

Adverse event outcomes for dietary combined with physical activity interventions vs usual care

All‐cause mortality · people at increased risk for developing type 2 diabetes

It is very uncertain whether diet plus physical activity changes all‐cause mortality compared with standard treatment (very low certainty).

1 finding from 1 review

Adverse event outcomes for dietary combined with physical activity interventions vs usual care

Development of type 2 diabetes · people at increased risk for developing type 2 diabetes

Diet plus physical activity probably leads to lower incidence of type 2 diabetes mellitus Diagnostic criteria: 3 trials… compared with standard treatment (moderate certainty).

1 finding from 1 review

Adverse event outcomes for dietary combined with physical activity interventions vs usual care

Cardiovascular mortality · people at increased risk for developing type 2 diabetes

It is very uncertain whether diet plus physical activity changes cardiovascular mortality compared with standard treatment (very low certainty).

1 finding from 1 review