DZD scientists at the University of Tübingen identified a phenotype among patients with prediabetes that is associated with nonresponse to lifestyle modification in the Tübingen Lifestyle Intervention Program (TULIP). These participants showed a lack of reversal of prediabetes (impaired glucose tolerance and/or impaired fasting glucose) to normal glucose regulation (NGR) despite reduction of body weight. Characteristics of non-responders were low insulin secretion relative to insulin resistance or insulin-resistant nonalcoholic fatty liver disease (= high-risk phenotype). The odds ratio for reaching the status NGR was 4.54 (95% CI 2.08, 9.94) for participants having the low-risk phenotype.
In future, stratification of individuals with prediabetes at baseline into a high-risk and a low-risk phenotype may help to determine the effectiveness of a lifestyle intervention to revert individuals to NGR. The next question is: Can a reduced response to a standard
lifestyle intervention in individuals with the identified high-risk phenotype be overcome by an intensified lifestyle intervention? The German Prediabetes Lifestyle Intervention Study (PLIS) has been started in eight centres throughout Germany to investigate this issue.
Stefan N, Staiger H, Wagner R, Machann J, Schick F, Häring HU, Fritsche A. A high-risk phenotype associates with reduced improvement in glycaemia during a lifestyle intervention in prediabetes. doi: 10.1007/s00125-015-3760-z. Diabetologia. September 24, 2015
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