New research published today in Teh Lancet suggests a critically important link between prediabetes management and long-term cardiovascular health. An international team of researchers has found that individuals with prediabetes who successfully lower their blood sugar through lifestyle changes can substantially reduce their risk of serious heart events and premature death. The findings, based on decades of data from studies in the U.S.and China, offer a potential paradigm shift in preventative cardiology and highlight a readily measurable target for improved patient outcomes.
People with prediabetes who successfully lower their blood sugar levels through lifestyle changes can halve their risk of heart attack, heart failure, and early death, according to a groundbreaking international study. The research, published in the medical journal The Lancet, offers a new perspective on preventing cardiovascular disease. “This finding could revolutionize prevention and establish a new, measurable target for guidelines,” experts at the University Hospital Tübingen wrote.
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Researchers from the German University Hospital, the German Center for Diabetes Research (DZD), and the Helmholtz Association participated in the study. A recent scientific evaluation of 6.4 million fasting blood sugar tests in Austria revealed that approximately one in five adults in Austria has prediabetes. Fasting blood sugar levels – also known as blood glucose – exceeding 97 milligrams per deciliter are considered an indicator. Prediabetes is also defined as a mid-term blood sugar level (HbA1c) between 5.7 percent and 6.4 percent. Two measurements with HbA1c values greater than 6.5 percent suggest diabetes. The HbA1c level measures the sugar load on red blood cells.
Millions Affected
“Millions of people… live with elevated blood glucose levels without knowing it. They are considered ‘pre-diabetic’ – an early stage that has, until now, lacked a clearly defined therapeutic target,” the University Hospital Tübingen stated in a press release. Individuals with prediabetes are typically advised to lose weight, increase physical activity, and adopt a healthier diet. However, a critical question remained unanswered: does this also protect the heart in the long term? “Until now, no lifestyle program for people with prediabetes has convincingly demonstrated that it sustainably reduces heart attacks, heart failure, or cardiovascular deaths over decades,” the hospital explained.
The new study provides significant answers. It’s a combined analysis of two of the world’s largest diabetes prevention studies – one from the United States and one from China. Working with co-authors from both countries, the German researchers found that achieving normal blood sugar levels through lifestyle changes, rather than the changes themselves, is the key factor. This corresponds to a remission of a precursor to diabetes, and has significant implications for public health.
Long-Term Data from 2,400 Participants Analyzed
The scientific investigation analyzed long-term data from more than 2,400 people with prediabetes. The results showed that individuals who successfully normalized their blood glucose levels had a significantly lower risk of dying from cardiovascular disease or being hospitalized for heart failure compared to those whose glucose levels remained elevated – even when both groups lost weight to a similar extent.
“In both studies, the risk of cardiovascular death was reduced by around 50 percent for participants, and overall mortality (all causes) also decreased significantly. The American study followed its participants for 20 years, while its Chinese counterpart tracked them for even longer – 30 years,” the German researchers involved in the study noted. They harmonized and re-evaluated the datasets from the Chinese and U.S. studies to compare rates of cardiovascular death and hospitalization for heart failure in individuals with and without prediabetes remission.
A New, Measurable Goal for Medicine
Cardiovascular prevention has traditionally relied on three pillars: blood pressure control, lowering LDL cholesterol, and smoking cessation. These new findings suggest a fourth element could be added: sustainable normalization of blood sugar in prediabetes.
“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 severe cardiovascular diseases in the long term, over decades,” said Andreas Birkenfeld, board member of the German Diabetes Research Center (DZD) and medical director of the Medical Clinic IV at the University Hospital Tübingen.
Measuring HbA1c isn’t even necessary. A fasting blood sugar level of no more than 97 milligrams per deciliter proved to be a simple marker for a permanently lower heart risk – regardless of age, weight, or ethnicity. Researchers emphasized that this threshold could be implemented in primary care practices worldwide, making prevention more accessible.
(Source: SN, APA)
