Prediabetes, a condition with elevated blood sugar levels that often goes undetected due to a lack of symptoms, affects an estimated one in ten adults—though the actual number may be higher. It increases the risk of developing type 2 diabetes, which can lead to severe complications like cardiovascular disease or cancer. The condition arises when the body’s cells become resistant to insulin, causing blood sugar levels to rise.
An analysis of a large Tübingen study shows that patients who bring their blood sugar levels back within the normal range through a healthy lifestyle but do not lose weight, or even gain weight, still reduce their risk of type 2 diabetes by 71 percent. Researchers from the University Hospital of Tübingen, Helmholtz Munich, and the German Center for Diabetes Research (DZD) were involved in the study, published on Nature Medicine.
You can find here the abstract of the paper:
Clinical practice guidelines recommend defined weight loss goals for the prevention of type 2 diabetes (T2D) in those individuals with increased risk, such as prediabetes. However, achieving prediabetes remission, that is, reaching normal glucose regulation according to American Diabetes Association criteria, is more efficient in preventing T2D than solely reaching weight loss goals. Here we present a post hoc analysis of the large, multicenter, randomized, controlled Prediabetes Lifestyle Intervention Study (PLIS), demonstrating that prediabetes remission is achievable without weight loss or even weight gain, and that it also protects against incident T2D. The underlying mechanisms include improved insulin sensitivity, β-cell function and increments in β-cell-GLP-1 sensitivity. Weight gain was similar in those achieving prediabetes remission (responders) compared with nonresponders; however, adipose tissue was differentially redistributed in responders and nonresponders when compared against each other—while nonresponders increased visceral adipose tissue mass, responders increased adipose tissue in subcutaneous depots. The findings were reproduced in the US Diabetes Prevention Program. These data uncover essential pathways for prediabetes remission without weight loss and emphasize the need to include glycemic targets in current clinical practice guidelines to improve T2D prevention.
