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Effectiveness of lifestyle modification in prediabetes remission among women with isolated impaired fasting glucose: A community-based, randomised controlled trial in India

Authors: Mathews, E. and Nair Anand, T. N. and Joseph, A. and Kodapally, B. and Pilankatta, R. and Narayan, K. M. V. and Oldenburg, B. and Thankappan, K. R.

Year: 2026 Journal: Diabetes Res Clin Pract Vol/Issue: Vol. 232 Pages: 113106

Study Characteristics

Lifestyle Pillars
ConnectednessNutritionPhysical ActivityRestorative Sleep
Study Design
RCT

Abstract

Aims

We evaluated the effectiveness of a lifestyle modification (LSM) intervention in prediabetes remission among women with isolated impaired fasting glucose (i-IFG).

Methods

We conducted a community-based, parallel-group, open-label, randomised controlled trial in Kerala, India. Women aged 30-60 years with i-IFG were randomly assigned (1:1) to receive either a 12-month LSM program or standard care (diabetes information booklet). Randomization was computer-generated with allocation concealed until assignment. The primary outcome was prediabetes remission based on oral glucose tolerance testing at 12 months. Secondary outcomes included progression to type 2 diabetes and changes in glycaemic markers, anthropometric measures, body composition, and blood pressure. Analyses followed the intention-to-treat approach.

Results

Of 1092 participants randomised, 1080 (98.9 %) completed the 12-month follow-up. Prediabetes remission was significantly higher in the LSM group than in controls (45.9 % vs 6.3 %; RR 7.04, 95 % CI 5.12-10.06). LSM also produced greater improvements in fasting plasma glucose (-5.2 mg/dL), HbA1c (-0.09 %), HOMA2-IR (log) (-0.38), weight (-3.7 kg), waist circumference (-1.4 cm), fat mass (-2.9 kg), and fat-free mass (+0.86 kg). The number needed to treat for prediabetes remission was 2.8 (1.8-4.0).

Conclusion

A structured LSM intervention effectively promotes prediabetes remission in women with i-IFG and improves cardio metabolic health.