TY - JOUR
T1 - Impact of lifestyle changes on prediabetes remission
T2 - Results from the Pakistan diabetes prevention trial
AU - Ahmed, Asma
AU - Ahmed, Salaar
AU - Shah, Wasiat Hasan
AU - Iqbal, Romaina
AU - Akhter, Jaweed
AU - Jabbar, Abdul
AU - Azam, Iqbal
AU - Awan, Safia
AU - Tuomilehto, Jaakko
N1 - Publisher Copyright:
© 2025 Elsevier B.V.
PY - 2026/1
Y1 - 2026/1
N2 - Background: This study evaluated the effectiveness of a culturally adapted lifestyle intervention in prediabetes remission to normoglycemia and reducing diabetes progression. Methods: In two sub-towns of Karachi, 3945 adults were screened with the Indian Diabetes Risk Score; 2165 high-risk participants (aged 30–64 years) were randomized to lifestyle intervention or standard care. The intervention included nine structured sessions on diet, activity, and weight management, plus SMS reminders, cooking demonstrations, and counseling. Participants were followed for two years. Results: Mean age was 44 years, and 74 % were women; 43 % had prediabetes at baseline. Reversal to normoglycemia occurred in 61 % and 62 % of the intervention group at one and two years versus 39 % and 37 % in standard care (AOR = 2.46, 95 % CI: 1.84–3.29, p < 0.0001). Lower prediabetes remission was observed among overweight (AOR = 0.65), pre-obese (AOR = 0.59), and obese participants (AOR = 0.74). Remission was lower in areas with parks (AOR = 0.77, p = 0.0001). Metabolic syndrome participants in the intervention had higher remission rates (AOR = 4.13). Those with impaired fasting glucose showed markedly greater remission odds (AOR = 8.21). Conclusion: Culturally tailored lifestyle interventions can significantly induce prediabetes remission, highlighting scalable, low-cost prevention strategies for Pakistan and other LMICs.
AB - Background: This study evaluated the effectiveness of a culturally adapted lifestyle intervention in prediabetes remission to normoglycemia and reducing diabetes progression. Methods: In two sub-towns of Karachi, 3945 adults were screened with the Indian Diabetes Risk Score; 2165 high-risk participants (aged 30–64 years) were randomized to lifestyle intervention or standard care. The intervention included nine structured sessions on diet, activity, and weight management, plus SMS reminders, cooking demonstrations, and counseling. Participants were followed for two years. Results: Mean age was 44 years, and 74 % were women; 43 % had prediabetes at baseline. Reversal to normoglycemia occurred in 61 % and 62 % of the intervention group at one and two years versus 39 % and 37 % in standard care (AOR = 2.46, 95 % CI: 1.84–3.29, p < 0.0001). Lower prediabetes remission was observed among overweight (AOR = 0.65), pre-obese (AOR = 0.59), and obese participants (AOR = 0.74). Remission was lower in areas with parks (AOR = 0.77, p = 0.0001). Metabolic syndrome participants in the intervention had higher remission rates (AOR = 4.13). Those with impaired fasting glucose showed markedly greater remission odds (AOR = 8.21). Conclusion: Culturally tailored lifestyle interventions can significantly induce prediabetes remission, highlighting scalable, low-cost prevention strategies for Pakistan and other LMICs.
UR - https://www.scopus.com/pages/publications/105022647957
U2 - 10.1016/j.diabres.2025.113019
DO - 10.1016/j.diabres.2025.113019
M3 - Article
AN - SCOPUS:105022647957
SN - 0168-8227
VL - 231
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 113019
ER -
