Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS)
An erratum to this article was published (Lancet Diabetes Endocrinol, Jan 2024 ↗)
Authors' conclusion
By contrast to remission of type 2 diabetes, resolution of prediabetes was characterised by an improvement in insulin sensitivity and reduced VAT. Because return to normal glucose regulation (NGR) prevents development of type 2 diabetes, we propose the concept of remission of prediabetes in analogy to type 2 diabetes. We suggest that remission of prediabetes should be the primary therapeutic aim in individuals with prediabetes.
Study context
- Population
- People with prediabetes in PLIS (8 centres, Germany) who lost ≥5% bodyweight with lifestyle or control intervention; validation in Diabetes Prevention Program (DPP) (23 centres, USA)of 1160 in PLIS
- Participants
- 298 people
- Comparison
- Responders vs non-responders after ≥5% weight loss
- Respondersn = 128
- Non-respondersn = 170reference
- Primary endpoint
- Insulin sensitivity, insulin secretion, visceral adipose tissue (VAT) and intrahepatic lipid content (IHL), by linear mixed models
- Follow-up
- 12 months
Methodological detailsprespecified post-hoc analysis, multicentre, validated in DPP cohort
- Prespecified post-hoc analysis
- Multicentre
- Validated in DPP cohort
Primary result
As reported in the abstract
- Responders vs Non-responders: P < 0.0001
- Responders vs Non-responders: P = 0.46
- Responders vs Non-responders: P = 0.34
- Responders vs Non-responders: P = 0.0003
Further findings
Age · baseline
P < 0.0001
DPP validation cohort responders
- BMI reduction · baseline to 12 months · Similar: 32.4 to 29.0 vs 32.1 to 29.2 kg/m²
- P = 0.86
- DPP validation cohort responders: 683 participants with ≥5% weight loss
Risk of developing T2D · 2 years after intervention
- Lower risk of T2D in responders vs non-responders
- 73%
Original publication
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