Glycemic Control Trumps Weight Loss for Type 2 Diabetes Prevention, with Arvid Sandforth, MD

New research posits that prediabetes remission based off of achieving glycemic targets should be the primary treatment goal for type 2 diabetes (T2D) prevention, rather than weight loss targets.

These findings were presented by primary investigator Arvid Sandforth, MD, physician scientist, Institute of Diabetes Research and Metabolic Diseases, Tübingen, Germany, at the 2025 American Diabetes Association (ADA) Scientific Sessions, held June 20-23, in Chicago, Illinois.

HCPLive spoke with Sandforth during the meeting to learn more about how prediabetes remission has emerged as an effective target for preventing T2D. Sandforth gave an overview of the pre-diabetes lifestyle intervention study he investigated, which is a multicenter study from the German Center for Diabetes Research. He shared some exciting findings from the study, which found that, across subgroups of weight loss, weight stability, and weight gain, achieving normal glycemia provided the same protective effect against developing T2D. While he stressed that losing weight remains the most effective way to reach pre-diabetes remission, achieving glycemic control seems to be the more important factor even if weight is not lost.

“[This] ties in into the concept of clinical obesity as a general concept that's being put forward more and more. And I think that's very important… it's not overweight or obesity per se. It's the wrong lipids at the wrong place,” Sandforth said. “T2D, that's hyperglycemia, [is] the thing we're trying to prevent. So why not look at glycemia when it comes to prevention? Why not introduce glycemic targets as an add on?”

Sandforth has no disclosures to report.

REFERENCE

Sandforth A, Sandforth L, Katzenstein S, et al. Achieving Prediabetes Remission during Lifestyle Intervention Is More Effective Than Weight Loss for Type 2 Diabetes Prevention. Presented at: ADA 2025; June 20-23; Chicago, Illinois. Presentation #163-OR