Prediabetic? Stay that way. Maintaining prediabetic status could reduce the risk of diabetic complications

Researchers have established an association between the number of years without diabetes following a diagnosis of glucose intolerance and the risks of mortality and cardiovascular incidents.Patients living with prediabetes can delay the diagnosis of type 2 diabetes through lifestyle interventions, including better eating habits and more physical activity. To limit the risks of complications linked to the disease, the onset of diabetes should ideally be postponed for at least four years. In a post-hoc analysis, published in PLOS Medicine, data from 540 patients from the Da Qing Diabetes Prevention Study (DQDPS) were examined. This study recruited participants with glucose intolerance to conduct trials on lifestyle modification and its effect on diabetic status.Followup at two, four and six years made it possible to check whether the non-diabetic status had been maintained (maintenance of prediabetes or regression towards normal glucose tolerance) or if it had progressed towards type 2 diabetes. Then, for more than 30 years, researchers monitored complications related to the disease and whether individuals were diagnosed with diabetes or not. They noted severe microvascular (retinopathy, nephropathy and neuropathy) and macrovascular complications.From the four-year followup, significant differences were observed between those who remained non-diabetic and those who had progressed to the disease. The 30-year risk of cardiovascular complications decreased by almost 40% in those who had maintained a prediabetic status for all these years (HR: 0.63; 95% CI: 0.49-0.82). The risk of death from all causes decreased by 26% for these individuals (HR=0.74; 95% CI: 0.57-0.97). At the two-year followup, these effects were not observed in participants who had progressed to diabetes. There would be benefits in postponing the diagnosis even longer. Those who were still free of diabetes after six years of followup saw their risk of death from heart disease drop by 44% (HR: 0.56; 95% CI: 0.39-0.81).“These results suggest that, for the population at high risk of diabetes, a threshold of four years in the duration of maintaining non-diabetic status could reduce the risk of death and cardiovascular complications,” said the team of Chinese researchers. “There would therefore be a window of opportunity of a few years to make a change in lifestyle habits and thus limit long-term complications.” The study was conducted with participants from the Chinese population only, which in itself constitutes a limitation, the authors said. Demographic and cultural variations, such as obesity rates, smoking status and access to healthcare could vary the results if the methodology is reproduced in other regions of the world.

Prediabetic? Stay that way. Maintaining prediabetic status could reduce the risk of diabetic complications

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