People with prediabetes who bring their blood sugar levels back into the normal range may be significantly less likely to develop serious cardiovascular disease, according to new research from King’s College London. Lancet Diabetes and Endocrinology.
The study found that normalizing blood sugar levels and reversing prediabetes reduced the risk of death from cardiovascular disease and hospitalization for heart failure by more than 50%.
This finding is particularly noteworthy because recent research suggests that lifestyle changes such as increased physical activity, weight loss, and improved diet alone are not sufficient to reduce cardiovascular risk in people with prediabetes.
Taken together, these results indicate that remission of prediabetes may represent a powerful new target for preventing heart disease and improving long-term health outcomes. The findings may also have implications for how doctors treat patients with prediabetes.
“This study challenges one of the biggest assumptions in modern preventive medicine. People with prediabetes have long been told that they can protect themselves from heart attack and early death by losing weight, increasing physical activity, and eating a healthier diet. While these lifestyle changes are undoubtedly valuable, the risk of heart attack and death in people with prediabetes is lower. “There is no evidence that prediabetes remission is associated with a clear reduction in fatal cardiac events, heart failure, and all-cause mortality,” explained study lead author Dr. Andreas Birkenfeld, reader in diabetes at King’s College London and Tübingen University Hospital.
More than 1 billion people worldwide have pre-diabetes
Prediabetes occurs when blood sugar levels are elevated but not high enough to meet the criteria for type 2 diabetes. Many people with prediabetes eventually develop type 2 diabetes, but this condition itself is also associated with an increased risk of cardiovascular disease, one of the world’s leading causes of death.
This condition is very common. Around one in five adults in the UK have either diabetes or pre-diabetes. It affects more than one in three adults in the United States, but in China, that number rises to four in 10. Researchers estimate that more than 1 billion people worldwide have prediabetes.
Long-term study reveals lasting heart benefits
A research team led by Dr. Andreas Birkenfeld from King’s College London and Tübingen University Hospital reviewed data from two major diabetes prevention studies: the Diabetes Prevention Program Outcomes Study (DPPOS) in the United States and the DaQing Diabetes Prevention Outcomes Study (DaQingDPOS) in China.
Both studies followed prediabetic patients over several decades and included interventions such as increased physical activity and healthier eating habits.
Researchers found that participants who achieved remission of prediabetes had a 58% lower risk of cardiovascular death or hospitalization for heart failure. This benefit remains evident decades after blood sugar levels return to normal, suggesting that the effects of blood sugar normalization may be long-lasting.
The analysis also showed that people who reversed prediabetes had a 42% lower risk of heart attack, stroke, and other major cardiovascular events.
Importantly, this result was consistent in both the U.S. and Chinese study populations.
Why remission of prediabetes is more important than lifestyle changes alone
A previous analysis of the same study found that combining lifestyle interventions such as increased physical activity and a healthier diet did not significantly reduce the risk of cardiovascular disease.
Researchers say this shows that simply delaying the onset of diabetes may not be enough to protect the heart. Substantial cardiovascular benefits may require significant metabolic improvements, such as achieving remission of prediabetes.
“The findings mean that remission of prediabetes may be established as the fourth major primary prevention measure to truly prevent heart attacks and death, alongside lowering blood pressure, lowering cholesterol and quitting smoking,” Dr Birkenfeld added.
international research cooperation
The research is part of the Transcampus Partnership, a long-term collaboration between King’s College London and TUD Dresden University of Technology.
“Transcampus is a unique partnership established by King’s College London and TUD Dresden University of Technology as a cross-border strategic partnership based on the idea of true cooperation and an enthusiasm for cooperation in all fields. Common ideas, values, research and education “Guided by our dedication to , Transcampus allows researchers to collaborate beyond traditional means of partnership by sharing resources, mobilizing each other’s strengths, and fostering cross-border projects and knowledge transfer,” said Dean Professor Stefan Bornstein. Transcampus.

