New research has shown that people with prediabetes can lower their risk of developing type 2 diabetes—even if they don’t lose weight.
This surprising finding comes from a large study in Tübingen, Germany, and has been published in the journal Nature Medicine.
The research team included experts from University Hospital Tübingen, Helmholtz Munich, and the German Center for Diabetes Research (DZD).
Millions of people worldwide have prediabetes. It’s a condition where blood sugar levels are higher than normal but not yet high enough for a diabetes diagnosis. Often, people don’t even know they have it because it causes no symptoms at first.
In prediabetes, the body becomes less sensitive to insulin, a hormone that helps move sugar from the blood into the body’s cells. As a result, sugar builds up in the blood. If left untreated, prediabetes can lead to type 2 diabetes—a serious disease that affects more than 460 million people worldwide and raises the risk of heart disease and cancer.
Until now, weight loss has been the main goal of treatment for prediabetes. Doctors have advised healthy eating and exercise to help people lose weight and lower their blood sugar. But the new study suggests there’s more to the story.
Researchers found that even if people don’t lose weight, they can still lower their blood sugar to normal levels—and this greatly reduces their risk of getting type 2 diabetes.
The study followed more than 1,100 people with prediabetes who joined a lifestyle program focused on eating better and being more active. After one year, 234 participants had not lost any weight—or had even gained some.
But surprisingly, 22% of this group still managed to bring their blood sugar back to normal. Over the next nine years, those who normalized their blood sugar without losing weight were 71% less likely to develop diabetes. That’s almost the same benefit seen in people who did lose weight (73%).
The researchers say the key may be fat distribution in the body. There are two main types of fat: visceral fat, which is deep inside the belly around the organs, and subcutaneous fat, which sits just under the skin.
Visceral fat is especially dangerous because it releases chemicals that cause inflammation and disrupt hormones. This can make the body more insulin-resistant. In the study, people who lowered their blood sugar without weight loss still had reductions in abdominal fat, which may explain the improvement in their metabolism.
Professor Andreas Birkenfeld, one of the study leaders, says the focus should be on bringing blood sugar back to normal, not just watching the scale. Exercise and healthy food can improve blood sugar even without visible weight loss.
Losing weight can still help, but it’s not the only way to protect against diabetes. Professor Reiner Jumpertz-von Schwartzenberg, who also worked on the study, believes that future health guidelines should include blood sugar control and fat distribution—not just body weight—as important treatment goals.
In summary, remission of prediabetes—bringing blood sugar back to a healthy level—is the most effective way to prevent diabetes. And this study shows that it can happen without losing weight. But regular physical activity and a balanced diet remain essential tools for reaching this goal.
If you care about blood sugar, please read studies about why blood sugar is high in the morning, and how to cook sweet potatoes without increasing blood sugar.
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