Reversing Prediabetes May Cut Heart Risk by 58%, New Research Finds

Reviewed by the HealthyMag Editorial Team. Last updated: July 2026.

Prediabetes can feel like a scary label, but new research offers a genuinely hopeful message: getting your blood sugar back into the normal range appears to be linked with a substantially lower risk of serious heart problems. In June 2026, researchers reported that people who reversed prediabetes to normal glucose levels had far fewer heart attacks, strokes, heart-failure hospitalizations, and cardiovascular deaths than those who stayed in the prediabetes range.

The finding matters because prediabetes is extremely common — affecting roughly one in three American adults, most of whom don’t know they have it — and because heart disease, not diabetes itself, is the leading cause of death in people with elevated blood sugar. If reversing prediabetes really does track with a healthier heart, it strengthens the case for acting early. Here’s exactly what the study found, what “reversing prediabetes” means, and the proven, realistic ways to do it.

What the new 2026 research found

The study, led by researchers at King’s College London together with University Hospital Tuebingen and published in The Lancet Diabetes & Endocrinology, pooled long-term data from two major diabetes-prevention cohorts: the US Diabetes Prevention Program Outcomes Study (DPPOS) and the Chinese Da Qing Diabetes Prevention Outcomes Study. Both followed people with prediabetes for many years, which allowed the researchers to compare heart outcomes between those who returned to normal blood sugar (normoglycaemia) and those who did not.

The headline numbers were striking. Participants who achieved remission of prediabetes — meaning their blood glucose normalized — had:

• A 58% lower risk of cardiovascular death or hospitalization for heart failure.
• A 42% lower risk of major cardiovascular events, a category that includes heart attack and stroke.

These are large reductions, and they were seen consistently across two very different populations on opposite sides of the world, which adds weight to the signal. It’s an encouraging result that reframes prediabetes not as an inevitable slide toward diabetes and heart disease, but as a state that can, for many people, be turned around.

One important nuance from the analysis deserves emphasis. The researchers noted that lifestyle changes on their own — exercising more, losing weight, improving diet — did not, in these data, clearly reduce cardiovascular risk unless they actually resulted in blood sugar returning to normal. In other words, it may be the metabolic outcome (normalized glucose), rather than the effort alone, that tracks most closely with a healthier heart. That distinction is scientifically interesting, and we’ll return to it when we discuss caveats.

What prediabetes is

Prediabetes means your blood sugar is higher than normal, but not yet high enough to be classified as type 2 diabetes. It’s diagnosed using standard blood tests, and the thresholds set by the American Diabetes Association (ADA) and echoed by the CDC are widely used worldwide.

The two most common tests are the A1c (also called HbA1c), which reflects your average blood sugar over the past two to three months, and fasting plasma glucose (FPG), measured after not eating for at least eight hours.

A third test, the oral glucose tolerance test (OGTT), can also be used: a 2-hour glucose of 140–199 mg/dL indicates prediabetes. Diagnoses are usually confirmed with a repeat test on a separate day. “Reversing” prediabetes simply means moving your numbers back below the prediabetes cutoffs — into the normal column.

Why reversing it may protect the heart

The link between blood sugar and the heart is well established biologically, which is part of why the new findings are plausible. Even before someone reaches full diabetes, mildly elevated glucose and the insulin resistance that often accompanies it can quietly stress the cardiovascular system.

Elevated blood sugar is associated with damage to the inner lining of blood vessels (the endothelium), promotion of inflammation, and unfavorable shifts in blood fats and blood pressure — all of which can accelerate the buildup of plaque in arteries. Insulin resistance also tends to travel with other cardiovascular risk factors, including higher triglycerides, lower HDL cholesterol, and abdominal weight gain. When blood sugar returns to normal, it’s reasonable to think some of these pressures ease.

Weight loss, which is the most common driver of prediabetes reversal, has its own heart benefits: it can lower blood pressure, improve cholesterol and triglyceride levels, and reduce the workload on the heart. So there are several biologically sensible pathways by which returning to normal blood sugar could accompany a healthier heart. That said, “biologically plausible” is not the same as “proven,” which brings us to the most important caveat.

The caveat: association versus causation

This is the part every reader deserves to hear clearly. The 2026 study is a post-hoc analysis of observational cohort data — not a randomized controlled trial designed to test whether reversing prediabetes prevents heart events. That design has real limitations.

Observational studies can show that two things travel together, but they can’t fully prove that one causes the other. Two issues are worth naming:

• Confounding: People who successfully return to normal blood sugar may differ in many ways from those who don’t — they might be more physically active, eat differently, take other medications, or be healthier overall for reasons that themselves protect the heart.
• Reverse causation and healthy-responder effects: The people whose blood sugar normalizes may be those with milder or earlier metabolic disease to begin with, and that underlying difference — rather than the reversal itself — could partly explain the lower heart risk.

The researchers’ own observation reinforces caution: lifestyle change by itself didn’t clearly lower cardiovascular risk in this data unless blood sugar actually normalized. That could mean the glucose outcome is what matters — or it could reflect the fact that people who respond metabolically are a distinct, perhaps lower-risk group. Only a randomized trial can settle this. For now, the honest interpretation is: this is a strong, consistent association that fits decades of prior evidence — encouraging, but not proof.

How to reverse prediabetes

Here’s the genuinely good news: the ways to move prediabetes back toward normal are well studied and achievable, and they don’t require anything exotic. The evidence base is anchored by the landmark Diabetes Prevention Program (DPP), a large US randomized trial published in the New England Journal of Medicine in 2002.

In the DPP, an intensive lifestyle program cut the risk of progressing from prediabetes to type 2 diabetes by 58% compared with placebo — more than the medication metformin, which reduced risk by 31%. The lifestyle intervention had two concrete goals that remain the practical playbook today:

• Modest weight loss: a target of at least 7% of body weight. For someone weighing 200 pounds, that’s about 14 pounds. Even 5–7% makes a meaningful difference.
• Physical activity: at least 150 minutes per week of moderate-intensity movement, such as brisk walking — roughly 30 minutes, five days a week.

Diet is the third pillar. There’s no single “prediabetes diet,” but approaches that consistently help include cutting back on refined carbohydrates and sugary drinks, filling half your plate with vegetables, choosing whole grains and legumes, and being mindful of ultra-processed foods high in salt and sugar. If you’re weighing eating strategies, our comparison of intermittent fasting versus calorie counting walks through the trade-offs of two popular approaches to reducing intake, and our look at the hidden salt content in takeaway food is a reminder of why cooking more meals at home tends to help.

Notably, the DPP’s lifestyle intervention worked across ethnic groups and both sexes, and was most effective in adults aged 60 and older, who saw a 71% risk reduction — a helpful counter to the idea that it’s “too late” to act.

Realistic expectations

Reversal is common but not guaranteed, and results vary from person to person. Some people normalize their blood sugar within a few months of sustained changes; for others it takes a year or more, and some don’t fully reverse despite real effort. Genetics, how long blood sugar has been elevated, sleep, stress, and other health conditions all play a role.

Weight regain is also realistic to plan for. In the DPP, participants lost an average of about 7 kg (roughly 15 pounds) in the first year, then regained some over time — which is why the framing that works best is sustainable habits, not a short-term diet. Blood sugar can also drift back up even after reaching normal, so periodic retesting matters.

It’s worth being clear-eyed about the newest finding, too: the 58% and 42% figures describe an association observed in existing cohorts, not a promise of individual results. The realistic takeaway is that returning to normal blood sugar is a worthwhile, evidence-aligned goal — one with well-documented metabolic benefits regardless of how the heart question is ultimately resolved.

When to see a doctor / medication

If you have a prediabetes diagnosis, or risk factors like a family history of diabetes, higher body weight, high blood pressure, or a history of gestational diabetes, talk with your doctor about testing and a personalized plan. Regular A1c or fasting glucose checks let you track progress and catch changes early.

Lifestyle change is first-line, but medication has a role for some people. Metformin is sometimes prescribed for prediabetes, particularly in higher-risk individuals, and newer weight-management medications are changing the landscape — our overview of the oral weight-loss drug orforglipron covers one recent development. Any medication decision should be made with a clinician who knows your full history.

Finally, if you’re digging into your cardiovascular risk more broadly, blood-sugar status is only one piece. Cholesterol matters too, and the type of cholesterol testing can affect how accurately your risk is assessed — see our explainer on ApoB versus standard LDL cholesterol testing. Crucially: never start, stop, or change a prescribed medication on your own based on a news article. Use findings like these as a prompt to talk with your care team, not as a substitute for it.

Frequently Asked Questions

Can prediabetes be reversed?

Yes, for many people. Reversing prediabetes means bringing your blood sugar back below the prediabetes thresholds — an A1c under 5.7% or fasting glucose under 100 mg/dL. The landmark Diabetes Prevention Program showed that intensive lifestyle changes cut progression to diabetes by 58%, and many participants returned to normal glucose. Reversal isn’t guaranteed for everyone, but it’s a realistic goal for a large share of people.

What is a prediabetes A1c level?

An A1c between 5.7% and 6.4% indicates prediabetes. Below 5.7% is considered normal, and 6.5% or higher on two tests indicates diabetes. A1c reflects your average blood sugar over the past two to three months, so it’s a useful way to track whether your numbers are trending back toward normal.

How long does it take to reverse prediabetes?

It varies. Some people see their blood sugar normalize within three to six months of consistent changes to diet, activity, and weight; for others it takes a year or longer, and some don’t fully reverse despite real effort. Because A1c reflects a two-to-three-month average, allow at least a few months between tests to see meaningful change.

Does reversing prediabetes lower heart risk?

A 2026 study in The Lancet Diabetes & Endocrinology found that people who reversed prediabetes to normal blood sugar had a 58% lower risk of cardiovascular death or heart-failure hospitalization and a 42% lower risk of heart attack, stroke, and other major events. Importantly, this is an observational association, not proof of cause and effect — but it aligns with strong prior evidence linking blood sugar to heart health.

What is the best diet for prediabetes?

There’s no single required diet, but effective approaches share common features: fewer refined carbohydrates and sugary drinks, more vegetables, whole grains and legumes, lean proteins, and limited ultra-processed foods. Mediterranean-style eating and lower-carbohydrate patterns both have supportive evidence. The best diet is ultimately one that lowers your blood sugar and that you can sustain long term.

How much weight do I need to lose to reverse prediabetes?

The Diabetes Prevention Program targeted a loss of at least 7% of body weight — about 14 pounds for a 200-pound person — combined with 150 minutes of weekly activity. Even a 5–7% reduction can meaningfully improve blood sugar. You don’t need to reach an “ideal” weight; modest, sustained loss is what drove the benefits in the research.

Will prediabetes turn into diabetes?

Not necessarily. Without intervention, many people with prediabetes do progress to type 2 diabetes over time, but that path is not inevitable. Lifestyle change substantially lowers the risk of progression, and some people return to normal blood sugar entirely. Regular testing and early action are the best ways to change the trajectory.

The Bottom Line

Prediabetes is not a life sentence. The 2026 research adds an encouraging data point to a well-established story: returning your blood sugar to normal is associated with a substantially lower risk of serious heart problems, with reductions of 58% for cardiovascular death or heart failure and 42% for major events like heart attack and stroke. The finding is observational, so it shows a strong link rather than definitive cause and effect — but it fits decades of trial evidence that weight loss, better food, and more movement can move prediabetes back toward normal. Results vary, reversal isn’t guaranteed, and the smartest move is to partner with your doctor on a plan that fits your life. The overarching message is empowering: early, sustainable action genuinely matters, and it’s rarely too late to start.

Sources

1. ScienceDaily. “Reversing prediabetes to normal blood sugar linked to sharply lower heart risk” (King’s College London / University Hospital Tuebingen, The Lancet Diabetes & Endocrinology, June 2026). https://www.sciencedaily.com/releases/2026/06/260613034237.htm
2. Knowler WC, et al. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine, 2002 (Diabetes Prevention Program). https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp
3. American Diabetes Association. “Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026.” Diabetes Care. https://diabetesjournals.org/care/article/49/Supplement_1/S27/163926/2-Diagnosis-and-Classification-of-Diabetes
4. American College of Cardiology. “Diabetes Prevention Program (DPP) Trial” summary. https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2010/02/23/19/02/DPP
5. The Diabetes Prevention Program Research Group. “Description of Lifestyle Intervention.” Diabetes Care (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC1282458/