The purpose of this study was to examine the effect of baseline characteristics on regression from pre-diabetes to normal glucose regulation as defined by the American Diabetes Association criteria. Participants of the Diabetes Prevention Program were randomized to: intensive lifestyle modification (ILM), 850 mg metformin twice daily or placebo. In those entering the study with both impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), male sex and insulin sensitivity predicted regression to isolated IFG whereas ILM, metformin, female sex and greater insulin secretion predicted regression to isolated IGT. Thus, some of the factors associated with the return to a normal glucose regulation are modifiable such as weight loss and additional aspects of ILM but insulin secretion and other biologic processes retained with younger age are playing an important role in the restoration of normal glucose regulation in people with pre-diabetes. Finally, the authors conclude that ILM and metformin are both two effective strategies for diabetes prevention but also focus on the importance of diabetes prevention through the restoration of normal glucose regulation.
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