Prediabetes: Blood Sugar More Likely to Return to Normal Than Progress to Type 2 Diabetes, Global Study Finds
Australia- A large-scale pooled analysis published in The Lancet Global Health suggests that individuals with prediabetes are more likely to return to normal blood sugar levels than develop type 2 diabetes (T2D) over a decade. The study, led by Najmeh Davoodian from Deakin University, Australia, examined global patterns in glycaemic transitions and associated risk factors using data from the Obesity, Diabetes and Cardiovascular Disease Collaboration.
The analysis included 76,092 adults from 19 prospective cohorts across Asia, Australia, Europe, North and South America, with a median follow-up of nearly 10 years.
The study led to the following findings:
- Among individuals with prediabetes at baseline, the 10-year probability of progressing to type 2 diabetes (T2D) was 12.5%, while 36.1% reverted to normoglycaemia.
- Participants with the highest fasting plasma glucose had a 16.1% risk of developing diabetes and only a 13.4% chance of returning to normal glucose levels.
- Men and those aged 55 years or older were more likely to progress to T2D.
- Latinx populations showed a higher risk of diabetes progression compared to other ethnic groups.
- Overweight and obesity lowered the chances of reversion to normoglycaemia, with obesity reducing the likelihood by 34%.
- Elevated waist-to-hip and waist-to-height ratios were associated with decreased reversion rates.
- Low HDL cholesterol levels also contributed to a reduced probability of returning to normoglycaemia.
“These findings highlight the importance of early detection and intervention in people at risk,” the authors noted, stressing that focusing solely on preventing progression may not be enough. Restoring normoglycaemia should also be a key target in public health strategies.
Unlike previous research that primarily explored progression to diabetes, this study offers comprehensive insights into both directions of transition—progression and reversion—while accounting for demographic and clinical variables. By pooling individual-level data from diverse ethnicities and socio-economic backgrounds, the analysis provides robust evidence for tailoring interventions globally.
The authors emphasized that rising rates of prediabetes worldwide, coupled with varying transition risks across age, sex, and ethnicity, demand personalized prevention approaches. They also pointed out that individuals with higher baseline fasting plasma glucose represent a critical group for targeted strategies.
"With type 2 diabetes continuing to pose a major global health challenge, the findings advocate for a dual approach: reducing the incidence of diabetes while enhancing efforts to restore normal glycaemic status through lifestyle modification and risk factor management," the authors concluded.
Reference:
Davoodian, N., Lotfaliany, M., Huxley, R. R., Lee, C. M. Y., Pasco, J. A., Adams, R. J., Azizi, F., Bertoni, A. G., Björkelund, C., Colagiuri, S., Fahimfar, N., Gabriel, R., Giedraitis, V., Gill, T. K., González, C., Gregg, E. W., Hadaegh, F., Hange, D., Harland, J. W., . . . Mohebbi, M. (2025). Prediabetes transitions to normoglycaemia or type 2 diabetes and associated risk factors in the Obesity, Diabetes and Cardiovascular Disease Collaboration: An individual-level pooled analysis of 19 prospective cohort studies. The Lancet Global Health, 13(9), e1533-e1542. https://doi.org/10.1016/S2214-109X(25)00237-2
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