Prev Med Rep. 2026 Jul 13;69:103571. doi: 10.1016/j.pmedr.2026.103571. eCollection 2026 Sep.
ABSTRACT
OBJECTIVE: To identify the optimal 2-h glucose reduction and baseline level for preventing progression from impaired glucose tolerance to type 2 diabetes using meta-regression.
METHODS: We systematically reviewed randomized clinical trials of lifestyle modifications and/or anti-hyperglycemic medications reporting both 2-h glucose and diabetes prevention in impaired glucose tolerance. PubMed (1997), Cochrane Library (1995), and Ichushi-Web (Japanese medical literature database; 2000) were searched from inception through January 26, 2025. A meta-regression model examined log-transformed hazard ratios for diabetes progression, with 2-h glucose reduction and baseline level as predictors.
RESULTS: From 1372 candidates, 32 studies (n = 33,839 participants) were analyzed. The model indicated linear relationship and the early intervention at a baseline 2-h glucose of 140 mg/dL (7.8 mmol/L) could prevent 44% of diabetes with only a 10 mg/dL (0.56 mmol/L) reduction. Conversely, later interventions at a baseline 2-h glucose of 170-190 mg/dL (9.4-10.6 mmol/L) require larger 2-h glucose reductions of 20-30 mg/dL (1.1-1.7 mmol/L) for similar preventive effects (40-42%); which may necessitate pharmacotherapy.
CONCLUSIONS: This meta-regression analysis demonstrates that early and minimal interventions for impaired glucose tolerance are optimal, suggesting that its timely detection is vital for diabetes prevention.
PMID:42502745 | PMC:PMC13400255 | DOI:10.1016/j.pmedr.2026.103571
