Diabetes Prevention Program Cancellation a ‘Colossal Waste’

Investigators are searching for a way forward after two long-term diabetes programs were terminated following the cancellation of their National Institutes of Health (NIH) funding, the result of federal allegations that study coordinator Columbia University had inappropriately handled antisemitism on campus.

The programs include the three-decades-old Diabetes Prevention Program (DPP) and its offshoot, the Diabetes Prevention Program Outcomes Study (DPPOS).

“We are reeling,” said David Nathan, MD, a previous chair of both the DPP and the DPPOS and an original leader of the landmark Diabetes Control and Complications Trial. Nathan is also founder of the Massachusetts General Hospital Diabetes Center in Boston, one of the 30 DPPOS sites in 21 states.

On March 7, the Trump administration cancelled $400 million in awards to Columbia University from various federal agencies.

While Columbia University agreed on March 21 to changes in policies and procedures to respond to the Trump administration’s charges, in the hopes that the funding would be restored, DPPOS Principal Investigator Jose Luchsinger, MD, told Medscape Medical News that as of press time, the study was still cancelled.

Decades of Research

Following notification on March 9, investigators had to quickly cancel appointments with study participants in the program.

“The problem is that for studies with human subjects, and especially multicenter studies such as DPPOS, every day that goes by without funding, our valuable staff at our 30 centers are lost and the rent for research space and the cost of supplies are lost; the study begins to dissolve,” Nathan said. “Our connection with our loyal participants is also lost,” he said, noting that some 3100 people had volunteered, with most participating for two to three decades.

“We have already heard from several of our study centers that they may soon need to let their highly trained staff go,” Nathan said. “It’s really such colossal waste.”

The first DPP study, which began in 1996, found that lifestyle changes or taking metformin could prevent or delay the onset of type 2 diabetes. It spawned two large community-based efforts, the National Diabetes Prevention Program, overseen by the US Centers for Disease Control and Prevention, and the Medicare Diabetes Prevention Program.

DPPOS is the long-term follow-up of the DPP cohort, most of whom are now entering their 70s.

The DPPOS was beginning to study Alzheimer’s disease and dementia and continuing to investigate the long-term effects of diabetes prevention on other conditions, such as cancer, heart disease and stroke, nerve damage, kidney disease, and eye disease.

With all study activity now at a standstill, investigators have no idea where future funding may come from, if at all, Nathan said.

In response to a query from Medscape Medical News about the DPPOS grant cancellation, an NIH spokesperson said that, “in accordance with the Presidential Memo ‘Radical Transparency About Wasteful Spending,’ information on NIH’s terminated grants may be accessed” through a website compiling cancelled grants.

Caught Up in Columbia’s Troubles

The $16 million grant for the current phase of DPPOS was awarded in 2022 to Columbia University. The university was charged with the coordination across study sites, as that was deemed more efficient for the NIH, according to Nathan.

Noting that the majority of DPPOS is conducted outside of the New York-based university, Nathan called getting swept up into the federal dispute with Columbia “tragic.”

Despite Columbia agreeing to update its policies on discrimination, harassment, and free speech, the university has not said whether or when it would start receiving federal grants and contracts again. DPPOS investigators can’t wait, said Nathan. They have been reaching out to the media, members of Congress, and the administration to make a case that it’s imperative to restore funds to the prevention program before it is too late.

“The irony is that what we’re studying — chronic diseases like diabetes and dementia — are exactly what had been highlighted by Robert Kennedy, Jr, in his confirmation,” Nathan said, referring to the new Secretary of Health and Human Services. “Yet they’re cutting this program, which seems to be at odds with what their public health initiatives are. We’re trying to get people to see that.”

Widespread Concern

The American Diabetes Association (ADA) concurred, noting that ending DPP and DPPOS runs counter to HHS’ stated goals. Eliminating funding “means the loss of a decade’s worth of important findings and progress toward diabetes prevention and understanding Alzheimer’s disease and associated dementia in diabetes, a recent focus of the study,” the ADA said in a statement.

The ADA said it had expressed its concerns to Congress and the administration.

The Endocrine Society also is calling on the administration to restore DPPOS funding, citing concern about the impact of the study’s loss on the almost 39 million Americans with diabetes and close to 100 million Americans who have prediabetes.

Twenty-three Senate Democrats, led by Sen. Dick Durbin (D-IL) introduced a resolution in late February that “the National Institutes of Health should not experience any interruption, delay, or funding disruption in violation of the law and that the workforce of the National Institutes of Health is essential to sustaining medical progress.” 

But there have been no other congressional actions to stop cancellations of any NIH grants.

While biological specimens and data collected over the years through DPP and DPPOS are in a repository at the NIH, researchers theoretically can continue to access what has been archived and published, Nathan said. However, he worries that perhaps even that repository could be destroyed.

NIH is “the greatest scientific engine that we’ve ever had in medicine,” he said. “My fear is that it’s being dismantled as well.”

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.