The central role of recovery of β-cell function in the remission of prediabetes: a prospective cohort study in Canada
Authors' conclusion
Recovery of β-cell function is the dominant determinant of the remission of prediabetes, akin to its role in remission of diabetes but at an earlier point in the natural history of dysglycaemia.
Study context
- Population
- Women with prediabetes after pregnancy (visit 1), screened for GDM in pregnancy at Mount Sinai Hospital, Toronto, Canada, with a subsequent visit (visit 2) at 3 months, 1, 3 or 5 years postpartum787 screened
- Participants
- 182 women
- Exposure
- Remission vs no remission of prediabetes
- Remissionn = 100
- No remissionn = 82reference
- Outcome
- Changes in log Matsuda index, HOMA-IR, ISSI-2 and IGI/FPI between visits as predictors of remission of prediabetes (logistic regression adjusted for clinical diabetes risk factors)
- Follow-up
- Visit 2 (median 13.0 months [11.8-27.9] postpartum)
Methodological detailssingle-centre, serial postpartum OGTTs, Enrolment Sept 22, 2003 to Nov 30, 2018, Visit 1 at median 3.5 months (IQR 3.0-12.3) postpartum
- Single-centre
- Serial postpartum OGTTs
- Enrolment Sept 22, 2003 to Nov 30, 2018
- Visit 1 at median 3.5 months (IQR 3.0-12.3) postpartum
Main finding
As reported in the abstract
Between-visit change as predictor of remission
Change in log ISSI-2, aOR
3.80 (1.53-9.41) (95% CI)
Change in log Matsuda index, aOR
2.28 (1.21-4.31) (95% CI)
Top-ranked predictor: change in log ISSI-2, change in model deviance
8.49
Second-ranked: change in log Matsuda index, change in model deviance
6.56
Observational data: associations, not effects.
Further findings
| Outcome | Remission | No remission | P value |
|---|---|---|---|
| ISSI-2 at baseline (visit 1)Higher with Remission · median | 576 (IQR 493–674) | 496 (IQR 391–600) | P < 0.0004 |
| Matsuda index at visit 2Higher with Remission | 5.8 (IQR 3.9–7.9) | 3.9 (IQR 2.6–6.7) | P = 0.0004 |
| ISSI-2 at visit 2Higher with Remission | 650 (IQR 563–820) | 478 (IQR 389–590) | P < 0.0001 |
| IGI/FPI at visit 2Higher with Remission | 1.9 (IQR 1.2–2.5) | 1.3 (IQR 0.8–2.0) | P = 0.0002 |
Original publication
The central role of recovery of β-cell function in the remission of prediabetes: a prospective cohort study in Canada. Lancet Diabetes Endocrinol. Published 11 August 2025. doi:10.
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