Scientists say they say

Millions of people around the world live with diabetes. It is estimated that one in ten adults is affected, although the number of unreported cases means the real figure is much higher. Prediales is a condition in which blood sugar values ​​are high but do not yet meet the criteria for diabetes. It often remains undetected for a long time, as affected individuals initially have no symptoms. The body’s cells become more resistant to the endogenous hormone insulin. As a result, less sugar moves from the blood into the body’s cells and the blood sugar level increases. The risks are high: If left untreated, there is a high risk of developing type 2 diabetes later – a disease that affects more than 460 million people worldwide. It can lead to serious complications, such as cardiovascular disease or cancer.

Normal blood sugar level is electrolyte

Strategies recommended to date – including in current guidelines – for preventing type 2 diabetes in people with the disease before have focused primarily on reducing weight through a healthy diet and increasing physical activity. This strategy, limited to weight alone, can be expanded on the basis of new analysis results.

A long-term study conducted by the Department of Diabetes, Endocrinology and Nephrology at University Hospital Tübingen showed that 234 of more than 1,100 study participants did not lose any weight or even gain weight over the course of a year despite lifestyle changes. However, 22 percent of them normalized their blood sugar levels. The development of type 2 diabetes was monitored over a period of up to a further 9 years. Without weight loss, this group was 71 percent less likely to develop diabetes. This number is almost identical to individuals who were able to reduce their risk of developing type 2 diabetes by losing weight (73 percent).

Fat distribution is a critical factor

The analysis showed special attention to fat distribution. The relationship between visceral fat (internal abdominal fat surrounding the organs) and subcutaneous fat (fatty tissue located directly under the skin) was examined. Visceral fat releases molecules that promote inflammation and disrupt hormone balance, leading to insulin resistance and thus directly linked to type 2 diabetes. Study participants whose blood sugar levels returned to normal without weight loss had a lower percentage of belly fat as a result of lifestyle changes compared to those whose blood sugar levels remained in the diabetic range.

Body weight is no longer the only indicator

“Restoring a normal fasting blood sugar level is the most important goal in preventing type 2 diabetes and is not necessarily the number on the scale,” says Professor Dr. Andreas Birkenfeld, study leader and Director of the Institute for Diabetes and Metabolic Disease Research (IDM) at the University of Tübingen. “Exercise and a balanced diet have a positive effect on blood sugar levels, regardless of whether weight has been lost. Weight loss remains beneficial, but our data suggest that it is not necessary to protect against diabetes,” he continues. “In the future, type 2 diabetes guidelines should not only take into account, but above all patterns of blood glucose control and fat distribution,” adds Prof. Dr. Rainer Jumpertz-Von Schwartzenberg, who participated in the latest study along with Prof. Dr. Birkenfeld.

A healthy lifestyle is a recipe for success

However, the study results highlight the importance of including target glycemic values, i.e. guideline blood sugar values, in practice guidelines in addition to weight reduction goals. Diabetes remission is the most effective way to prevent type 2 diabetes in the future, and the analysis suggests this is partly independent of weight loss. However, adequate physical activity and a balanced diet remain the main means of bringing blood sugar values ​​into the normal range.