Blood sugar control in prediabetes lowers risk of microvascular complications

Blood sugar regulation in prediabetes lowers risk of microvascular complications. finds a new study.

Regression from prediabetes to normal glucose regulation (NGR) lowers the risk of microvascular disease (MVD), nephropathy, and retinopathy primarily due to lower blood sugar exposure over time finds a recent study. The study highlights the importance of diabetes prevention interventions and to bring blood sugar and HbA1c in preventing its associated complications. The study has been published in the Diabetes Care journal.

Diabetes complications are divided into microvascular (due to damage to small blood vessels) and macrovascular (due to damage to larger blood vessels) which may occur due to poor blood sugar control. Microvascular complications include damage to eyes (retinopathy) leading to blindness, to kidneys (nephropathy) leading to renal failure and to nerves (neuropathy) leading to impotence and diabetic foot disorders (which include severe infections leading to amputation).It is a common complication associated with type 2 diabetes.

The Diabetes Prevention Program Outcomes Study (DPPOS) has shown the association between regression from prediabetes to NGR and a reduced diabetes incidence by 56% over 10 years.

In this observational analysis, Leigh Perreault, University of Colorado Anschutz Medical Campus, Aurora, CO, and colleagues examined whether regression to NGR also reduced the risk for microvascular disease.

The researchers examined the prevalence of aggregate MVD at DPPOS year 11 in people who regressed to NGR at least once (vs. never) during the Diabetes Prevention Program (DPP) through generalized estimating equations. The relationship of NGR with retinopathy, nephropathy, and neuropathy, individually was assessed through logistic regression.

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Key findings include:

• Regression to NGR was associated with a lower prevalence of aggregate MVD in models adjusted for age, sex, race/ethnicity, baseline A1C, and treatment arm.


• this association was lost in models that included average A1C during follow-up or diabetes status at the end of follow-up.


• Similar results were observed in the examination of the association between regression to NGR and prevalence of nephropathy and retinopathy, individually.


• The risk for aggregate MVD, nephropathy, and retinopathy increased across the A1C range.

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Bringing back blood sugar and A1C levels in normal range or regression to normal glucose regulation is associated with a lower prevalence of aggregate MVD, nephropathy, and retinopathy, primarily due to lower glycemic exposure over time. The differential risk for the microvascular disease (MVD) subtypes begins in the prediabetes A1C range.