New research demonstrates that individuals with prediabetes who can postpone the onset of type 2 diabetes by just four years through lifestyle interventions experience substantial long-term health benefits, including reduced mortality and fewer diabetes-related complications.
A recent study published in PLOS Medicine [1] has revealed that individuals diagnosed with prediabetes can significantly reduce their long-term risk of death and diabetes-related health complications by delaying the onset of diabetes for as little as four years through diet and exercise interventions. The research, led by Guangwei Li of the China-Japan Friendship Hospital, provides compelling evidence for the importance of early lifestyle interventions in prediabetic individuals.
Study design and methodology
The researchers analysed health outcomes from 540 prediabetic individuals who participated in the original Da Qing Diabetes Prevention Study, a six-year trial conducted in Da Qing City, China, beginning in 1986. Participants were allocated to either a control group or one of three lifestyle intervention groups, which involved following a healthy diet, increasing physical activity, or a combination of both. The trial included a remarkable follow-up period of over 30 years.
Key findings
Li’s team assessed the long-term risk of mortality, cardiovascular events (including myocardial infarction, stroke, and heart failure), and other diabetes-related complications among the trial participants. The results showed that individuals who remained non-diabetic for at least four years after their initial diagnosis had a significantly lower risk of mortality and cardiovascular events compared to those who developed diabetes sooner.
Four-year threshold identified
Importantly, the study identified a crucial “four-year threshold” for maintaining pre-diabetic status. The protective effect was not observed in individuals who remained non-diabetic for less than four years, suggesting that this duration may be a critical target for intervention strategies.
Implications for clinical practice
The findings underscore the importance of implementing effective interventions targeting individuals with impaired glucose tolerance (IGT) as part of preventative management for diabetes and its associated vascular complications. Healthcare providers should emphasise the potential long-term benefits of maintaining non-diabetic status for as long as possible in prediabetic patients.
Limitations and future research
Whilst the study provides valuable insights, further research is needed to determine if the four-year threshold is universally applicable across different populations and to explore the specific mechanisms underlying the observed long-term benefits. Additionally, studies investigating the most effective intervention strategies for achieving and maintaining non-diabetic status in pre-diabetic individuals would be beneficial.
Conclusion
This landmark study highlights the significant impact that even a relatively short delay in diabetes onset can have on long-term health outcomes. As the global prevalence of prediabetes continues to rise, these findings emphasise the critical importance of early intervention and lifestyle modification in preventing or delaying the progression to type 2 diabetes.
Reference:
- Qian, X., Wang, J., Gong, Q., et. al. (2024). Non-diabetes status after diagnosis of impaired glucose tolerance and risk of long-term death and vascular complications: A post hoc analysis of the Da Qing Diabetes Prevention Outcome Study.
PLOS Medicine, 21(7), e1004419. https://doi.org/10.1371/journal.pmed.1004419
