Losing weight and adopting a healthy lifestyle can significantly reduce the risk of type 2 diabetes, but it may not be enough for everyone. Researchers found that people in a specific risk group, known as cluster 5, continued to experience rising blood sugar and a sharp decline in insulin production, despite substantial weight loss.
The study, conducted by scientists at the German Center for Diabetes Research, the University Hospital Tübingen, and Helmholtz Munich, analyzed data from the Tübingen Lifestyle Intervention Program. The program involved a two-year lifestyle intervention, followed by approximately nine years of monitoring.
Researchers identified six distinct risk groups for type 2 diabetes, which differ in the likelihood of developing the disease and related complications. Clusters 3 and 5 were found to have a particularly high risk of developing type 2 diabetes.
The latest analysis examined whether long-term weight loss and lifestyle-based diabetes prevention produced different results across these risk groups. They focused on participants who achieved substantial weight loss and maintained it over the long term.
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Professor Norbert Stefan, the study’s lead author, noted that individuals in cluster 5 showed increasing blood glucose levels and declining insulin secretion, despite a large and sustained weight loss of 8% over a nine-year period.
The analysis suggests that insulin resistance, linked to severe fatty liver disease, played a major role in the group’s worsening metabolic health. Fat accumulation in the liver may have impaired the ability of pancreatic beta cells to release insulin, contributing to higher blood sugar levels in people in cluster 5.
The findings support earlier evidence that fatty liver disease and insulin resistance are the main disease processes affecting people in cluster 5, making them especially vulnerable to both type 2 diabetes and cardiovascular disease.
The results indicate that people in cluster 5 may not receive the same metabolic benefits from lifestyle intervention as people in other risk groups, even with substantial and lasting weight loss. If future research confirms these findings, diabetes prevention may need to become more personalized, with people in high-risk groups requiring more intensive care or treatments designed to address their specific metabolic problems.
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The researchers noted that the study’s results have significant implications for the prevention and treatment of type 2 diabetes. By understanding the different risk profiles and biological mechanisms underlying the disease, healthcare providers may be able to develop more effective and targeted interventions to prevent or delay the onset of type 2 diabetes.
A one-size-fits-all approach to diabetes prevention may not be sufficient, and a deeper understanding of the underlying biological mechanisms is needed to develop effective prevention strategies. The study’s results highlight the importance of continued research into the causes and consequences of type 2 diabetes, and the need for personalized approaches to prevention and treatment.
The study’s findings were published in the scientific journal Diabetes, and provide new insights into the complex relationships between lifestyle, biology, and disease risk.
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