Healthcare (Commonwealth Union) – Up to the present, losing weight has been seen as the main therapeutic goal for people with prediabetes. However, a major study from Tübingen has revealed that individuals who manage to bring their blood sugar levels back to normal through healthy lifestyle changes—even without losing weight, or in some cases while gaining it—can still lower their risk of developing type 2 diabetes by as much as 71 percent. The research was carried out by scientists from the University Hospital of Tübingen, Helmholtz Munich, and the German Center for Diabetes Research (DZD).
Researchers of the study pointed out the significance of prediabetes as it affects millions of people worldwide—roughly one in ten adults—though the true figure is likely much higher due to undiagnosed cases. It occurs when blood sugar levels are elevated but not high enough to be classified as diabetes. Because it usually causes no noticeable symptoms, many people are unaware they have it. The condition is formed when the body’s cells lower their response to the hormone insulin, blocking glucose from efficiently entering the cells and causing blood sugar levels to get elevated. If left untreated, prediabetes significantly increases the likelihood of developing type 2 diabetes—a disease that affects over 460 million people globally and can lead to severe complications such as heart disease and cancer.
Normal blood sugar levels as a key goal for individuals, as diets packed with sugar has been significant issue in the past few decades. Traditional prevention strategies for type 2 diabetes in people with prediabetes—outlined in most current medical guidelines—have mainly emphasized weight loss through healthy eating and regular exercise. However, the new findings suggest that the focus could be widened beyond weight management alone.
In a long-term study led by the Department of Diabetology, Endocrinology and Nephrology at the University Hospital Tübingen, researchers followed more than 1,100 participants. Among them, 234 individuals either maintained their weight or gained weight over the course of a year, despite making lifestyle improvements. Still, about 22 percent of these participants successfully normalized their blood sugar levels. Over an additional follow-up period of up to nine years, this group was found to be 71 percent less likely to develop type 2 diabetes—nearly the same reduction (73 percent) seen among participants who had achieved weight loss.
Prior research however has shown that excess visceral fat (the deep abdominal fat surrounding internal organs) can increase the risk of type 2 diabetes for obese individuals. More recent research has indicated that mangoes may play a role in reducing the risk of the condition.
The research conducted in this study showed that fat distribution as a key factor, placing a strong emphasis on how body fat is distributed. Researchers compared visceral fat with subcutaneous fat, which lies just beneath the skin. Visceral fat is known to release signaling molecules that trigger inflammation and disrupt hormonal balance, fostering insulin resistance and thereby contributing directly to type 2 diabetes. Participants who managed to normalize their blood sugar levels without losing weight showed a reduction in abdominal fat through lifestyle changes, unlike those whose blood sugar levels stayed within the prediabetic range.
“Restoring a normal fasting blood sugar level is the most important goal in preventing type 2 diabetes and not necessarily the number on the scale,” explained Professor Dr. Andreas Birkenfeld, the study leader and director of the Institute for Diabetes Research and Metabolic Diseases (IDM) of Helmholtz Munich at the University of Tübingen. “Exercise and a balanced diet have a positive effect on blood sugar levels, regardless of whether weight is reduced. Losing weight remains helpful, but our data suggests that it is not essential for protection against diabetes,” he further stated. “In future, guidelines for the prevention and treatment of type 2 diabetes should not only take weight into account, but above all blood glucose control and fat distribution patterns,” said Prof. Dr. Reiner Jumpertz-von Schwartzenberg, who, as last author, was engaged in the research together with Professor Dr. Birkenfeld.
