Heart risks in prediabetes: Lowering blood sugar back into the normal range may dramatically cut the risk of serious heart complications in people with prediabetes, according to new research from King’s College London.
In an analysis published in The Lancet Diabetes & Endocrinology, researchers reported that people who achieved remission from prediabetes, meaning their blood glucose returned to normal levels, had a more than 50% lower risk of dying from cardiovascular causes or being admitted to hospital with heart failure. The team said the benefits appeared to last for decades, pointing to what they described as a long-term protective effect once glucose levels normalised.
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The findings stand out because previous research has suggested that lifestyle programmes alone, such as improving diet, increasing exercise and losing weight, do not consistently reduce cardiovascular events in people with prediabetes, even if they delay progression to type 2 diabetes. The new analysis argues that the key factor may be whether glucose levels actually return to normal, rather than simply improving lifestyle measures or postponing diabetes.
“This challenges a long-held belief in preventive medicine,” said lead author Dr Andreas Birkenfeld of King’s College London and University Hospital Tübingen, noting that while lifestyle changes remain important for overall health, the evidence does not clearly show they reduce heart attacks or mortality in people with prediabetes unless remission is achieved.
Prediabetes occurs when blood sugar levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. It is widely seen as a warning stage, but it is also linked to higher cardiovascular risk. Researchers estimate that more than a billion people worldwide may be living with prediabetes.
To examine the relationship between glucose normalisation and long-term heart outcomes, the team reanalysed data from two long-running studies: one based in the United States and another in China. Both tracked participants with prediabetes over decades and included interventions such as healthier diets and increased physical activity.
Across both datasets, the researchers found that participants who reached prediabetes remission had a 58% lower risk of cardiovascular death or heart-failure hospitalisation. They also had a 42% reduction in major cardiovascular events such as heart attack and stroke. Similar patterns were seen in both the US and Chinese cohorts.
