People with high-risk prediabetes benefit from intensive lifestyle intervention

More exercise and healthy eating behavior help many people with prediabetes to normalize their blood glucose levels and avoid developing type 2 diabetes. However, not everyone benefits from a conventional lifestyle intervention (LI). Recent studies show that already in prediabetes, there are different subtypes with different risk profiles. Researchers at the German Center for Diabetes Research (DZD) have therefore investigated in a multicenter randomized controlled trial whether people with prediabetes and a high risk benefit from an intensification of the intervention and how people with a low risk are affected by a conventional LI compared to no lifestyle changes.

The LI lasted 12 months in each case and the follow-up period was a further two years. A total of 1,105 individuals with prediabetes were investigated at various study sites in Germany and assigned to a high-risk or low-risk phenotype based on insulin secretion, insulin sensitivity, and liver fat content. 82% of participants completed the study.

Low-risk participants completed a conventional LI or took part in a control group that received only a one-time brief consultation. "After three years, glucose tolerance was more likely to normalize in participants with conventional LI than in those in the control group," said Professor Hans-Ulrich Häring of the German Center for Diabetes Research and last author of the study. There were hardly any differences in insulin sensitivity and secretion, liver fat content and cardiometabolic risk.