People with prediabetes are often advised to lose weight to lower their risk of developing type 2 diabetes. However, a new study suggests that weight loss alone may not be enough.
Researchers from the University of Tübingen in Germany, in collaboration with U.S. scientists from the Diabetes Prevention Program (DPP), found that the best way to prevent diabetes is to both lose weight and bring blood sugar levels back to normal.
Their findings, published in Diabetologia, suggest that current guidelines should change to include blood sugar normalization as a goal in diabetes prevention programs.
The Risks of Prediabetes
Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. It is a warning sign that a person is at high risk of developing the disease in the future. Without intervention, prediabetes can lead to serious complications, including heart attacks, strokes, and kidney failure.
To prevent this progression, organizations like the American Diabetes Association (ADA) recommend that people with prediabetes lose at least 7% of their body weight. This recommendation is based on earlier research from the Diabetes Prevention Program (DPP), which showed that weight loss can lower diabetes risk.
But is weight loss alone enough? The new study aimed to find out whether bringing blood sugar levels back to normal—essentially reversing prediabetes—could offer even better protection against diabetes.
What the Study Found
Researchers analyzed data from 480 people with prediabetes who participated in a one-year lifestyle intervention program as part of the DPP study. These individuals successfully lost at least 7% of their body weight through diet and exercise.
However, not all of them achieved remission of prediabetes, meaning their blood sugar levels remained in the prediabetes range.
Out of the 480 participants:
- 114 people managed to normalize their blood sugar levels, meaning their prediabetes went into remission.
- The remaining 366 participants lost weight but did not achieve significant improvements in blood sugar regulation.
The results were clear: those who both lost weight and normalized their blood sugar levels had a much lower risk of developing type 2 diabetes.
- People who achieved both goals had a 76% lower risk of developing diabetes compared to those who only lost weight but still had prediabetes.
- Over a 4-year period, none of the individuals who achieved blood sugar remission developed type 2 diabetes.
- In contrast, some participants who lost weight but still had prediabetes eventually developed diabetes.
What This Means for Diabetes Prevention
The study suggests that simply losing weight may not be enough to fully protect against diabetes. Instead, efforts should also focus on normalizing blood sugar levels. This means that diabetes prevention programs should not only track weight loss but also monitor fasting blood sugar, glucose tolerance, and HbA1c levels (a measure of long-term blood sugar control).
The researchers believe that clinical guidelines should be updated to reflect this new understanding. By adding blood sugar remission as a treatment goal, healthcare providers can help patients significantly reduce their risk of diabetes.
The Bigger Picture
This study builds on growing evidence that early intervention can prevent or delay type 2 diabetes. It also highlights the need for personalized treatment approaches—some people may need more than just weight loss to achieve the best protection against diabetes.
Future research should explore ways to help more people achieve both weight loss and blood sugar normalization, whether through specific diets, exercise routines, or medical interventions.
For now, people with prediabetes should not only focus on losing weight but also work closely with their doctors to monitor and improve their blood sugar levels. This combined approach could offer the strongest protection against diabetes and its life-threatening complications.
If you care about diabetes, please read studies about Vitamin D and type 2 diabetes, and to people with diabetes, some fruits are better than others.
For more health information, please see recent studies that low calorie diets may help reverse diabetes, and 5 vitamins that may prevent complication in diabetes.
The research findings can be found in Diabetologia.
Copyright © 2025 Knowridge Science Report. All rights reserved.
