Prediabetes Reversal may not reduce Mortality Risk, but exercise does improve survival

A new study by Zhi Cao and team showed that the risk of mortality associated with reversion to normoglycemia varied depending on whether people were obese or physically active, even while it did not reduce the overall risk of death compared to chronic prediabetes throughout a 3-year period. The findings of this study were published in Journal of American Medical Association.

The risk of mortality is greater for those with prediabetes than for healthy people. Yet, prior research has indicated that those who go from prediabetes to normoglycemia may not have a decreased chance of dying than people who have continuous prediabetes. In order to clarify the involvement of modifiable risk factors in these connections, this study was done to look into the relationships between changes in prediabetes status and risk of mortality.

Data from the Taiwan MJ Cohort Study's 45 782 prediabetic patients who were enrolled between January 1, 1996, and December 31, 2007 were utilized in this population-based prospective cohort analysis. During the second clinical appointment through December 31, 2011, participants were followed up with a median (IQR) follow-up of 8 (5–12) years. Following initial registration, participants were divided into 3 groups based on changes in their prediabetes condition over the course of three years: persistent prediabetes, reversion to normoglycemia, and advancement to diabetes. The connections between changes in baseline prediabetes status and risk of mortality were investigated using Cox proportional hazards regression models. Between September 18, 2021, and October 24, 2022, data analysis was carried out.

The key findings of this study were as follows:

Among the 45 782 prediabetic patients, 1786 (3.9%) went on to acquire diabetes, while 17 021 (37.2%) returned to normoglycemia. 

In comparison to chronic prediabetes, the progression from prediabetes to diabetes during a 3-year period was linked to greater chances of all-cause and CVD-related death, but the return to normoglycemia was not linked to a decreased risk of either of these conditions. 

Reversion to normoglycemia was linked to a decreased risk of mortality from all causes among those who were physically active compared to people with chronic prediabetes who were sedentary. 

The risk of dying varied among obese people depending on whether they returned to normoglycemia or maintained chronic prediabetes.

In conclusion, these results underline how crucial lifestyle changes are for those with prediabetes.

Reference: 

Cao, Z., Li, W., Wen, C. P., Li, S., Chen, C., Jia, Q., Li, W., Zhang, W., Tu, H., & Wu, X. (2023). Risk of Death Associated With Reversion From Prediabetes to Normoglycemia and the Role of Modifiable Risk Factors. In JAMA Network Open (Vol. 6, Issue 3, p. e234989). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.4989