More than a billion people worldwide have prediabetes – elevated blood sugar levels that haven't yet reached the threshold for type 2 diabetes. A new study now shows that actively reversing this condition offers lasting protection for the heart.
Researchers led by Dr. Andreas Birkenfeld from King's College London and the University Hospital Tübingen analyzed two large long-term studies with decades of follow-up – the US Diabetes Prevention Program and the Chinese DaQing Study. The results, published in The Lancet Diabetes & Endocrinology, showed that participants whose blood sugar returned to normal levels had a 58 percent lower risk of dying from cardiovascular disease or being hospitalized with heart failure. The risk of major cardiovascular events such as heart attack or stroke decreased by 42 percent.
Remarkably, this protective effect lasted for decades. In contrast, lifestyle interventions alone – meaning more exercise and healthier eating without actual normalization of blood sugar – showed no significant effect on cardiovascular events in the same studies. "True remission is crucial, not just delaying diabetes," emphasizes Birkenfeld. Prediabetes remission could thus establish itself as the fourth major pillar of prevention – alongside blood pressure control, cholesterol management, and smoking cessation.
Globally, approximately one in three adults in the US and nearly one in five in the UK are affected by prediabetes. The study results suggest that doctors should not only encourage a healthier lifestyle but also actively aim for a return to normal blood sugar levels.
Source: Birkenfeld A et al., The Lancet Diabetes & Endocrinology (2026), DOI: 10.1016/S2213-8587(25)00295-5
