Those reversing prediabetes show improvement in insulin sensitivity but not greater weight loss than those not achieving remission
By Lori Solomon HealthDay Reporter
WEDNESDAY, Oct. 11, 2023 (HealthDay News) — Weight loss-driven remission of prediabetes protects against type 2 diabetes and is associated with better kidney and vascular function, according to a study published online Sept. 25 in The Lancet Diabetes & Endocrinology.
Arvid Sandforth, M.D., from the University of Tübingen in Germany, and colleagues investigated the mechanisms of weight loss-induced remission in people with prediabetes. The analysis included participants in the Prediabetes Lifestyle Intervention Study (PLIS) and the Diabetes Prevention Program (DPP) study who were randomly assigned to receive a lifestyle intervention or placebo and who lost at least 5 percent of their body weight. Responders were defined as those who returned to normal fasting plasma glucose, normal glucose tolerance, and hemoglobin A1c (HbA1c) <39 mmol/mol after 12 months of lifestyle intervention or placebo or control intervention.
The researchers found that in PLIS, 25.7 percent of participants had weight loss of 5 percent or more of their body weight from baseline, and of these, 43 percent were responders. Among the 683 DPP participants who lost at least 5 percent of their body weight at baseline, 19 percent were responders. While body mass index reduction was similar between responders and nonresponders, whole-body insulin sensitivity increased more in responders than in nonresponders, but insulin secretion did not differ within groups over time or between groups. Intrahepatic lipid content decreased similarly in responders and nonresponders, but visceral adipose tissue decreased more in responders. In the two years after the intervention, responders had a 73 percent lower risk for developing type 2 diabetes than nonresponders.
“We suggest that remission of prediabetes should be the primary therapeutic aim in individuals with prediabetes,” the authors write.
Several authors disclosed ties to industry.
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