Reversing Prediabetes Can Cut Heart Attack Risk in Half

Prediabetes has long been viewed as a transitional metabolic stage before type 2 diabetes, but growing evidence shows it carries a substantial and independent risk for cardiovascular disease. New findings published in The Lancet Diabetes & Endocrinology provide strong clinical evidence that reversing prediabetes by restoring normal blood glucose levels can significantly reduce long-term heart-related complications and mortality (1^✔ ✔Trusted Source
Prediabetes remission and cardiovascular morbidity and mortality: post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study

Go to source). Prediabetes is defined as blood glucose levels that are higher than normal but below the diagnostic threshold for diabetes. Large population studies have shown that individuals with prediabetes already face an elevated risk of heart attack, heart failure, and cardiovascular death compared with people who have normal glucose regulation.

Evidence from Landmark Diabetes Prevention Trials

The analysis published in The Lancet Diabetes & Endocrinology reexamined long-term data from two major randomized diabetes prevention studies: the Diabetes Prevention Program Outcomes Study (DPPOS) conducted in the United States and the DaQing Diabetes Prevention Outcomes Study (DaQing DPOS) from China.

Both trials followed participants with prediabetes for several decades and originally assessed the effects of lifestyle interventions such as dietary changes, increased physical activity, and weight management. The current analysis focused specifically on cardiovascular outcomes among individuals who achieved prediabetes remission, defined as sustained normalization of blood glucose levels.

Prediabetes Remission Halves Serious Heart Outcomes

Across both study populations, individuals who achieved remission from prediabetes experienced a 58 percent lower risk of cardiovascular death or hospitalization for heart failure compared with those who remained prediabetic.

Importantly, this reduction in risk persisted decades after blood glucose levels returned to normal, suggesting that early correction of abnormal glucose metabolism leads to durable cardiovascular benefits rather than temporary improvement.

Marked Decline in Heart Attacks and Strokes

The researchers also evaluated major adverse cardiovascular events (MACE), which include heart attack and stroke. Participants who achieved prediabetes remission showed a 42 percent reduction in these events compared with individuals who did not normalize their blood sugar levels.

These associations were consistent across both the US and Chinese cohorts, strengthening the reliability and global relevance of the findings.

Why Glucose Normalization Matters More Than Lifestyle Alone

Previous analyses of the same trials had shown that combined lifestyle interventions alone did not significantly reduce cardiovascular events if blood glucose levels remained in the prediabetic range. This indicates that delaying diabetes onset without achieving true metabolic remission may not be sufficient to protect the heart.

The new findings emphasize that normalization of glucose metabolism, rather than lifestyle change alone, is the key factor linked to reductions in heart attack, heart failure, and cardiovascular mortality.

Takeaway

Long-term data from landmark trials published in The Lancet Diabetes & Endocrinology show that reversing prediabetes by restoring normal blood sugar levels can cut the risk of heart attack, heart failure, and cardiovascular death by nearly half. These results position prediabetes remission as a critical and measurable target for early and effective heart disease prevention.

Reference:

1. Prediabetes remission and cardiovascular morbidity and mortality: post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study - (https://www.thelancet.com/journals/landia/article/PIIS2213-8587(25)00295-5/fulltext)

Source-Medindia