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An elevated blood glucose stage one hour after the oral glucose tolerance take a look at (OGTT) indicators a important metabolic state—even earlier than prediabetes. Affected people reply significantly nicely to way of life interventions. This worth might change into a brand new clinically related biomarker—and allow extra focused, earlier prevention of kind 2 diabetes.
That is the conclusion reached by a crew from the College of Tübingen, Helmholtz Munich and the German Middle for Diabetes Analysis (DZD). This analysis, performed in cooperation with Prof. Michael Bergman from New York College, has now been printed in Metabolism.
Prediabetes is taken into account a precursor to kind 2 diabetes. Nonetheless, over 40% of individuals recognized with prediabetes don’t progress to diabetes inside a decade. Extra importantly, the ADA prediabetes standards fail to establish round 20% of people who later develop diabetes, leaving them with out an early warning. How can at-risk people be higher recognized and handled extra successfully?
A more in-depth take a look at the early stage of the metabolic dysfunction
To search out solutions to this query, researchers have been looking for extra exact markers. The one-hour plasma glucose focus (1h-PG) within the oral glucose tolerance take a look at (OGTT) appeared significantly related to them. That is the blood glucose stage that medical doctors decide precisely one hour after the affected person has ingested a glucose answer.
In response to the Worldwide Diabetes Federation (IDF), a worth of ≥ 155 mg/dl is taken into account an early indicator of impaired glucose regulation—usually earlier than fasting or two-hour values change into irregular. The hope is that this measurement might provide alternatives to establish at-risk people early and deal with them in a focused method.
Life-style intervention with a major impact
To check their speculation, researchers within the Tübingen Life-style Intervention Program (TULIP) intensively monitored 317 people with various ranges of glucose tolerance for 9 months. The aim of the life-style intervention was a weight lack of no less than 5% by means of a balanced food regimen and common train.
Members have been assigned to 3 teams based mostly on metabolic parameters:
with regular glucose regulation,
with remoted elevated 1-hour prostaglandin (different values, corresponding to fasting glucose and 2-hour prostaglandin, have been nonetheless regular),
with traditional impaired glucose regulation (prediabetes).
In the beginning of the research, it grew to become obvious that people with excessive 1-hour prostaglandin ranges have been metabolically intermediate between wholesome and unhealthy. Their insulin sensitivity and beta-cell perform have been impaired, and their liver and stomach fats ranges have been elevated, though nonetheless reversible.
After 9 months of intervention, insulin sensitivity and beta-cell perform improved considerably within the 1h-PG group, restoring to ranges akin to these of metabolically wholesome people. On the similar time, liver fats ranges normalized. These enhancements have been significantly much less pronounced within the prediabetes group.
Lengthy-term advantages: 80% decrease threat
Over a interval of as much as twelve years, a formidable impact was noticed: People with elevated 1-hour glucose ranges who participated within the intervention have been 80% much less prone to develop kind 2 diabetes than folks with prediabetes. Nearly half even achieved regular blood glucose ranges (normoglycemia)—twice as many as within the prediabetes group.
“Weight loss and reduced liver fat improved both insulin sensitivity and the ability of beta cells to respond to glucose. This normalization of key metabolic processes could be crucial for enabling the transition to stable, healthy glucose metabolism.” says Yiying Wang, the primary creator of the research and a MD scholar within the Division of Diabetology, Endocrinology and Nephrology of the College Hospital Tübingen and a Clinician Scientist within the DZD.
New prevention technique with sensible potential
The one-hour glucose worth proved to be probably the most delicate marker for the early detection of impaired glucose tolerance. It was considerably extra informative than the HbA1c worth, fasting glucose, or two-hour glucose. “This value apparently marks the optimal point in time to normalize metabolism,” feedback Prof. Dr. Andreas Birkenfeld, the senior creator of the research.
In response to Birkenfeld, the take a look at might probably allow the early identification and efficient therapy of at-risk people, lengthy earlier than prediabetes is recognized. This might set up the 1-hour post-load glucose (1h-PG) as a brand new, clinically related biomarker.
Extra info:
Yiying Wang et al, Life-style intervention is simpler in excessive 1-hour post-load glucose than in prediabetes for restoring β-cell perform, lowering ectopic fats, and stopping kind 2 diabetes, Metabolism (2026). DOI: 10.1016/j.metabol.2025.156430
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German Middle for Diabetes Analysis
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One-hour blood glucose stage: A greater likelihood to forestall diabetes (2025, November 12)
retrieved 12 November 2025
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