Fasting glucose and BMI help identify a higher risk of progression from prediabetes to Type 2 diabetes in young adults.
Since Type 2 diabetes is rising in adults under 40, tailored treatments are essential to prevent serious complications like heart disease, stroke, and kidney disease, beyond ‘one-size-fits-all’ approach.(1✔ ✔Trusted Source
Type 2 diabetes risk varied widely among adults 18-40 with prediabetes
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Early, profound intervention for high-risk of prediabetes, specifically in young adults is key to halting the progression of metabolic health issues.
The findings were revealed by recent research presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026.
Mary Rooney, Ph.D., M.P.H., lead author of the study and an assistant research professor in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said, “We know that as a whole, people with prediabetes are at higher risk for progression to Type 2 diabetes and its complications.”
What Are the FDA Eligibility Criteria for GLP-1RA Medications?
“The U.S. Food and Drug Administration (FDA) has approved treatment with the new weight-loss medications, called GLP-1 Receptor Agonists (GLP-1RA), for select patients who meet certain criteria.”
“We used these existing criteria to estimate the risk of developing Type 2 diabetes in young adults with glucose levels in the prediabetes range.” Some GLP-1 RA medications are FDA-approved for people with Type 2 diabetes and others to help facilitate weight loss when diet and exercise have not been effective.
The eligibility criteria for prescribing GLP-1 RA medications for weight loss include obesity (body mass index of 30 kg/m2 or higher), or overweight (body mass index of 27 kg/m2) plus at least one related condition, such as high blood pressure or high cholesterol.
GLP-1 RA medications are not FDA-approved for the prevention of Type 2 diabetes in people with prediabetes.
How Does High Fasting Glucose Affect Diabetes Progression?
For their analysis, investigators estimated the 5-year risk of progression from prediabetes to Type 2 diabetes in 662 young adults. Participants were followed for an average of seven years through one of three U.S.-based studies focused on young adult health and heart disease risk.
The analysis found:
- The 5-year risk of progression from prediabetes to Type 2 diabetes was 7.5% overall.
- The risk increased to 10.9% for individuals who met the criteria for treatment with a GLP-1RA medication for weight loss.
- In addition, the 5-year risk grew to 15.1% for those with higher levels of fasting glucose (110-125 mg/dL), and 24.8% for those with a higher fasting glucose and who met the criteria for treatment with a GLP-1 RA medication.
“Current approaches to Type 2 diabetes prevention are ‘one-size-fits-all.’ Our results signal that some people with prediabetes have a higher risk of progressing to Type 2 diabetes. These are the patients who may benefit from more targeted, intensive treatment than others,” said Rooney.
Is it Possible to Reduce Heart Health Risk via Targeted Prediabetes Care?
According to the American Heart Association, lifestyle changes, such as losing weight, eating healthy and engaging in regular, moderate physical activity, may reduce the progression of prediabetes to Type 2 diabetes, help manage Type 2 diabetes and mitigate other risk factors like high blood pressure, as well as heart attacks and stroke.
The study also raises the possibility that GLP-1 RA medications might be beneficial to prevent progression to Type 2 diabetes in people with prediabetes who meet the BMI measures for overweight or obesity and other weight-related health conditions.
“However, the cost-effectiveness of GLP-1 RA medications for Type 2 diabetes prevention, particularly in subgroups with the highest risk for Type 2 diabetes, is not yet known,” said Rooney.
Acting Early: How Lifestyle Changes and Medications Halt Type 2 Diabetes
“Different groups of people with Type 2 diabetes may need different prevention strategies based on their level of risk,” said Joshua J. Joseph, M.D., M.P.H., FAHA, ASCI, an American Heart Association volunteer expert and chair of the Lifestyle Diabetes Committee for the Association’s Council on Lifestyle and Cardiometabolic Health.
“A next step would be to study a larger and more diverse group of people so we can better understand how factors like where someone lives, such as a rural or urban setting, their background and their community influence risk.”
“These findings support the idea of acting early, before Type 2 diabetes and related heart or kidney conditions become more serious, using healthy lifestyle changes and, when needed, medications to lower risk, consistent with the cardiovascular-kidney-metabolic syndrome framework, which prioritizes early intervention.”
Reference:
- Type 2 diabetes risk varied widely among adults 18-40 with prediabetes – (https://newsroom.heart.org/news/type-2-diabetes-risk-varied-widely-among-adults-18-40-with-prediabetes?preview=5e21&preview_mode=True)
Source-Eurekalert