Regression from prediabetes to normoglycaemia and the role of cardiometabolic risk factors on the subsequent risk of developing type 2 diabetes
Authors' conclusion
Our results suggest that prioritising normoglycaemia restoration during the prediabetes stage in clinical guidelines may contribute to reducing the risk of type 2 diabetes, particularly when accompanied by favourable cardiometabolic health profiles.
Study context
- Population
- Individuals with prediabetes (FPG 5.6–6.9 mmol/l without other criteria for T2D) at baseline, with at least two follow-ups, prospective cohorts in the USA, Australia and Asia
- Participants
- 8,191 individuals
- Comparison
- Restoration of normoglycaemia vs persistent prediabetes at first follow-up
- Outcome
- T2D occurrence at subsequent follow-ups
- Follow-up
- Median intervals 2.9 years (IQR 2.3-9.0) and 3.1 years (IQR 2.6-3.6)
Methodological detailsindividual-level data, USA, Australia and Asia, hierarchical mixed-effects proportional hazards Weibull models, adjusted for age, sex and cardiometabolic risk factors
- Individual-level data
- USA, Australia and Asia
- Hierarchical mixed-effects proportional hazards Weibull models
- Adjusted for age, sex and cardiometabolic risk factors
Pooled result
As reported in the abstract
Risk of developing T2D
Lower risk of T2D with normoglycaemia restoration vs persistent prediabetes
51%
Further pooled results
T2D risk, normoglycaemia restoration with concurrent favourable cardiometabolic profiles vs persistent prediabetes
- Non-smokers: HR
- 0.20 (0.10, 0.31) (95% CI)
- Normal BMI: HR
- 0.16 (0.06, 0.27) (95% CI)
- Normal waist circumference: HR
- 0.22 (0.12, 0.33) (95% CI)
- Normal waist-to-height ratio: HR
- 0.15 (0.03, 0.26) (95% CI)
- Normal WHR: HR
- 0.17 (0.05, 0.28) (95% CI)
- Normal systolic blood pressure: HR
- 0.20 (0.11, 0.30) (95% CI)
- Normal diastolic blood pressure: HR
- 0.25 (0.12, 0.38) (95% CI)
- Normal triacylglycerol: HR
- 0.24 (0.13, 0.35) (95% CI)
- Normal HDL-cholesterol: HR
- 0.21 (0.13, 0.29) (95% CI)
- Subgroup analysis; even lower risks than with restoration alone
T2D risk, weight loss plus normoglycaemia restoration vs weight gain and persistent prediabetes
- Weight loss + normoglycaemia restoration vs weight gain + persistent prediabetes: HR
- 0.18 (0.07, 0.30) (95% CI)
Original publication
Regression from prediabetes to normoglycaemia and the role of cardiometabolic risk factors on the subsequent risk of developing type 2 diabetes. Diabetologia. Published 18 October 2025. doi:10.
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