Prediabetes Remission Cuts Heart Disease Risk by Over 50%

A large international analysis indicates that returning blood glucose levels to normal in people with prediabetes may dramatically lower the risk of fatal heart disease and other major cardiovascular events.

Achieving Remission Dramatically Reduces Cardiovascular Risk

Research published in The Lancet Diabetes & Endocrinology shows that restoring blood glucose levels to a normal range – effectively reversing prediabetes – reduces the risk of death from heart disease or hospital admission for heart failure by more than 50%.¹ This finding is particularly significant given recent research suggesting that lifestyle changes alone may not be enough to reduce cardiovascular risk in individuals with prediabetes.

Challenging Conventional Wisdom

The study challenges the long-held assumption that weight loss, increased exercise, and a healthier diet automatically protect individuals with prediabetes from heart attacks and early death. Dr. Andreas Birkenfeld, Reader in Diabetes at King’s College London and lead author of the study, explains, “Whereas these lifestyle changes are unquestionably valuable, the evidence does not support that they reduce heart attacks or mortality in people with prediabetes. Instead, we show that remission of prediabetes is associated with a clear reduction in fatal cardiac events, heart failure, and all-cause mortality.”¹

Prediabetes: A Global Health Concern

Prediabetes is a condition where blood glucose levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It affects a substantial portion of the global population. Worldwide, more than one billion people are estimated to have prediabetes.¹ In the UK, approximately one in five adults lives with diabetes or prediabetes. In the United States, that figure exceeds one in three, while in China, it reaches four in ten.¹ Even though often progressing to type 2 diabetes, prediabetes independently increases the risk of cardiovascular disease, a leading cause of death globally.³

Decades of Data Support Findings

The research re-examined data from two major diabetes prevention studies: the US Diabetes Prevention Program Outcomes Study (DPPOS) and the Chinese DaQing Diabetes Prevention Outcomes Study (DaQingDPOS).¹ These long-term investigations followed individuals with prediabetes for several decades, including interventions focused on increased physical activity and healthier diets.

Participants who achieved remission from prediabetes experienced a 58% lower risk of cardiovascular death or hospital admission due to heart failure. The protective effect persisted for decades after blood glucose levels normalized, indicating the potential for long-lasting health benefits from glucose control.¹ The risk of heart attack, stroke, and other major adverse cardiovascular events also fell by 42% among those who achieved remission.¹ These findings were consistent across both the Chinese and US datasets.

Remission as a Primary Prevention Tool

Earlier analyses of the same studies showed that lifestyle interventions alone did not reduce cardiovascular disease. This suggests that simply delaying the onset of diabetes may not be sufficient to protect the heart unless key metabolic changes occur.¹ Dr. Birkenfeld suggests that prediabetes remission could become a fourth major primary prevention tool, alongside lowering blood pressure, cutting cholesterol, and stopping smoking, to truly prevent heart attacks and deaths.¹

A Collaborative Research Effort

The function is a result of a long-standing collaboration between King’s College London and TUD Dresden University of Technology known as the transCampus.¹

References

1. Birkenfeld, A. L., et al. “Prediabetes remission and cardiovascular morbidity and mortality: post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study.” The Lancet Diabetes & Endocrinology, 12 December 2025, doi: 10.1016/S2213-8587(25)00295-5.