A new study suggests that treating all people with prediabetes in the same way may not be the best approach.
Researchers have found that some young adults with prediabetes have a much higher risk of developing type 2 diabetes than others, and they may need earlier and more targeted treatment.
The research was presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026, held in Boston from March 17 to 20. These meetings bring together experts to share the latest findings on health, prevention, and lifestyle-related diseases.
Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be called diabetes. It is often seen as a warning sign.
Many people with prediabetes will go on to develop type 2 diabetes if no action is taken. Type 2 diabetes is a serious long-term condition that can lead to heart disease, kidney failure, stroke, and damage to the eyes, nerves, and feet.
In recent years, more adults under the age of 40 have been diagnosed with prediabetes and type 2 diabetes. This trend is worrying because developing the disease at a younger age means a longer time living with its complications.
The study was led by Dr. Mary Rooney from Johns Hopkins Bloomberg School of Public Health. Her team wanted to understand how likely young adults with prediabetes are to develop type 2 diabetes and whether some groups face higher risks than others.
The researchers analyzed data from 662 young adults between the ages of 18 and 40. These participants were part of three long-term health studies in the United States. On average, they were followed for about seven years.
The results showed that the overall chance of developing type 2 diabetes within five years was about 7.5 percent. However, this risk was not the same for everyone.
For people who met the criteria to be prescribed a newer type of weight-loss medicine called GLP-1 receptor agonists, the risk increased to 10.9 percent.
These medicines are currently approved to treat diabetes or help with weight loss, especially in people who are overweight or obese and have other health problems like high blood pressure or high cholesterol.
The risk was even higher for people with elevated fasting blood sugar levels. Those with fasting glucose between 110 and 125 mg/dL had a 15.1 percent risk of developing type 2 diabetes within five years. For people who had both high fasting glucose and met the criteria for GLP-1 medications, the risk rose sharply to 24.8 percent.
These findings show that some people with prediabetes are much more likely to develop diabetes than others. This means that a simple, one-size-fits-all approach may not be enough.
Dr. Rooney explained that current treatment strategies often treat all people with prediabetes in the same way. However, this study suggests that people at higher risk may benefit from more intensive and personalized care.
At present, GLP-1 receptor agonist medications are not approved for preventing diabetes in people with prediabetes. They are mainly used for treating type 2 diabetes or supporting weight loss when lifestyle changes alone are not enough. However, the study raises the possibility that these medicines could help prevent diabetes in high-risk individuals.
Still, there are important questions that need to be answered. One major concern is cost. These medications can be expensive, and it is not yet clear whether using them for prevention would be cost-effective.
Experts also stress that lifestyle changes remain the foundation of diabetes prevention. Healthy eating, regular physical activity, and weight control can significantly reduce the risk of developing type 2 diabetes. These changes can also help manage blood pressure and improve overall heart health.
Dr. Joshua Joseph, an expert from The Ohio State University who was not involved in the study, said that different groups of people may need different prevention strategies. Factors such as where a person lives, their background, and their community may all influence their risk.
He also emphasized the importance of acting early. Preventing diabetes before it develops can reduce the risk of serious complications later in life.
The study does have some limitations. For example, it did not include a common blood test called hemoglobin A1c, which is often used to measure long-term blood sugar levels. Instead, the researchers relied on fasting blood glucose levels. This means that some cases of prediabetes may not have been fully captured.
In addition, the study was based on past data collected before some of the newer medications were widely used. More research is needed to confirm these findings in larger and more diverse populations.
Overall, the study highlights an important idea. Not all people with prediabetes have the same level of risk. By identifying those at highest risk early, doctors may be able to offer more effective and personalized treatments.
This approach could help prevent more cases of type 2 diabetes and reduce the burden of the disease in the future.
If you care about diabetes, please read studies about diabetes and vitamin B12, and the right diet for people with type 2 diabetes.
For more health information, please see recent studies about how to eat smart with diabetes, and turmeric and vitamin D: a duo for blood pressure control in diabetic patients.
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