THE study could lead to the development of more personalized interventions that prevent at-risk individuals from developing type 2 diabetes.
People with prediabetes have consistently high blood sugar levels but have yet to develop the symptoms of type 2 diabetes.
Over many years, the cells of people with this condition become increasingly resistant to the effects of insulin, the hormone that regulates blood sugar levels.
The transition to type 2 diabetes occurs when the pancreas can no longer compensate for this resistance by producing more insulin.
According to the Centers for Disease Control and Prevention (CDC), approximately 88 million adults in the United States have prediabetes, which not only increases their risk of type 2 diabetes, but also of heart disease and stroke.
More than 84% of individuals with prediabetes are unaware that they have it, the CDC report.
For people with prediabetes, strategies such as losing weight, having a more healthful diet, getting more exercise, and lowering levels of stress can reduce the risk of developing type 2 diabetes by up to 58%.
Among people over 60, lifestyle changes such as these can reduce the chances of developing diabetes even further, by as much as 71%.
But people with prediabetes are not a homogenous group. Now, a new study has identified six broad categories, with important differences in terms of outlook and the kinds of interventions that could delay or prevent diabetes.
Researchers at various institutions in Germany, including the University of Tübingen and the German Center for Diabetes Research, in Neuherberg, led the study, which has been published in Nature Medicine.
“For people with prediabetes, it has not been possible until now to predict whether they would develop diabetes and be at risk for serious complications such as kidney failure, or whether they would only have a harmless form with slightly higher blood glucose levels but without significant risk.”
The researchers tracked changes in the metabolism of 899 individuals at risk of diabetes who had enrolled in the Tübingen Family Study and Tübingen Lifestyle Program. Over 25 years, the scientists conducted repeated clinical and laboratory tests, as well as MRI scans. They then used a statistical technique called cluster analysis that identified six distinct groups of people with prediabetes based on eight core metabolic features.