Nature Medicine: Prediabetes Remission Is Possible Without Dieting or Weight Loss

A new study shows that prediabetes can go into remission—meaning blood sugar levels return to normal—even without weight loss. The findings were published in Nature Medicine.

About one in four participants in lifestyle intervention programs achieved this result, restoring glycemic control without losing weight.

Typically, people with prediabetes are advised to lose weight as the main way to prevent progression to type 2 diabetes—but for many, this is difficult to achieve. Researchers found that the key factor is not necessarily total body weight but rather fat distribution.

They discovered that in those who achieved remission without weight loss, fat was redistributed: the amount of visceral fat (deep fat around internal organs), which is metabolically harmful, decreased, while more fat accumulated in subcutaneous tissue. Subcutaneous fat releases hormones that can support insulin activity, whereas visceral fat promotes chronic inflammation and insulin resistance.

In addition, participants who experienced remission showed a natural increase in the activity of hormones mimicked by some new weight-loss drugs—such as GLP-1 agonists—which help the pancreas produce insulin when glucose levels rise.

From a practical perspective, this means that people with prediabetes may aim not only for weight reduction but also for metabolic improvements—redirecting fat and enhancing insulin sensitivity—even if their overall body weight remains stable.