Study finds normalising blood glucose with lifestyle could halve heart disease risk in prediabetics

Fasting blood glucose value of under 97 milligrams per decilitre proves to be a marker for a persistently lower risk of heart disease

Bringing blood glucose to normal range through lifestyle changes could halve the risk of heart attack, heart failure and premature death among prediabetics, according to a study.

Findings published in ‘The Lancet Diabetes and Endocrinology’ journal show that remission of prediabetes — achieving normal blood glucose levels — may establish a new, measurable target for clinical guidelines, according to researchers.

A fasting blood glucose value of under 97 milligrams per decilitre proved to be a simple marker for a persistently lower risk of heart disease, regardless of age, weight, or ethnic background, the researchers said.

This threshold could be applied in primary care practices worldwide, making prevention more tangible, they added.

“Our results suggest that remission of prediabetes not only delays or prevents the onset of type 2 diabetes, as already known, but also protects people from serious cardiovascular diseases in the long term, over the span of decades,” author Dr Andreas Birkenfeld, a board member of the German Center for Diabetes Research and medical director of the department of medicine at University Hospital Tübingen, said.

The team, including researchers from the US and China, analysed long-term data from more than 2,400 people with prediabetes. The participants’ risk of cardiovascular death reduced by roughly 50 per cent, with a significant lowering of overall mortality.

The US study followed its participants for 20 years, while the China one tracked participants for 30.

Cardiovascular prevention has so far rested on three pillars — blood pressure control, lowering LDL cholesterol, and smoking cessation. With the new findings, a fourth pillar could be added — a sustained normalisation of blood glucose in prediabetes, the team said.

“Reaching prediabetes remission is linked to a decades-long benefit, halving the risk of cardiovascular death or hospitalisation for heart failure in diverse populations. Targeting remission might represent a new approach to cardiovascular prevention,” the authors wrote.

Birkenfeld said, “We see a clear therapeutic window: If glucose levels are normalised already at the prediabetes stage, the long-term risk of heart attack, heart failure and premature death can be markedly reduced.”

“Our data support explicitly anchoring remission as a primary treatment goal in guidelines for the prevention of diabetes and cardiovascular disease,” the author said.

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