What did the research discover?
This study examined how weight loss affects prediabetes and whether it can lead to remission, similar to type 2 diabetes. Researchers analyzed data from two large studies: the Prediabetes Lifestyle Intervention Study (PLIS) in Germany and the Diabetes Prevention Program (DPP) in the United States. Participants who lost at least 5% of their body weight were included in the analysis.
In PLIS, out of 1,160 participants, 298 (25.7%) lost at least 5% of their weight after 12 months. Of these, 128 (43%) achieved normal blood sugar levels and were considered “responders,” while 170 (57%) did not and were “non-responders.” In the DPP validation group, 132 out of 683 (19%) were responders.
The study found that while both responders and non-responders lost a similar amount of weight, responders had:
- Greater improvements in insulin sensitivity, meaning their bodies used insulin more effectively (p<0.0001).
- More reduction in visceral fat (VAT)—the fat stored around internal organs, which is linked to diabetes risk (p=0.0003).
- No significant difference in insulin secretion or fat stored in the liver between the two groups.
Importantly, responders had a 73% lower risk of developing type 2 diabetes in the two years after the study ended, showing that weight loss alone is not enough—how the body responds to weight loss matters.
How can I apply this information?
This research suggests that reducing visceral fat and improving insulin sensitivity—not just losing weight—plays a key role in preventing type 2 diabetes. People with prediabetes who achieve normal blood sugar levels after weight loss may significantly lower their future risk of diabetes.
If you have prediabetes, focusing on improving insulin sensitivity and reducing visceral fat could be more important than just watching the number on the scale. This can be achieved through:
- Regular physical activity, especially strength training and aerobic exercise.
- A diet rich in whole foods, fiber, and healthy fats.
- Maintaining weight loss over time to support long-term metabolic health.
Because this study is research, more studies are needed to confirm these findings. However, the results support targeting prediabetes remission as a treatment goal, similar to how remission of type 2 diabetes is approached.
Source:
Sandforth A, von Schwartzenberg RJ, Arreola EV, Hanson RL, Sancar G, Katzenstein S, Lange K, Preißl H, Dreher SI, Weigert C, Wagner R. Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS). The Lancet Diabetes & Endocrinology. 2023 Nov 1;11(11):798-810. https://pubmed.ncbi.nlm.nih.gov/37769677/
