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Wang, Y. ; Sargent, J.L.* ; Mathieu, C.* ; Vazquez-Arreola, E.* ; Perreault, L.* ; Loos, R.J.F.* ; Lim, L.* ; Sandforth, L. ; Hanson, R.L.* ; Kullmann, S. ; Sbierski-Kind, J. ; Brucker, S.Y.* ; Hrabě de Angelis, M. ; Theis, F.J. ; Icks, A.* ; Mohebbi, D.* ; Stefan, N. ; Mohan, V.* ; Wang, T.* ; Preissl, H. ; Bergman, M.* ; Tuomilehto, J.* ; Hivert, M.* ; Franks, P.W.* ; Birkenfeld, A.L.

Type 2 diabetes prevention across the life course.

Nat. Med. 32, 2757-2773 (2026)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Type 2 diabetes (T2D) prevention efforts have largely focused on intervening when dysglycemia is already established. We propose that T2D prevention be reframed around prediabetes remission, with preservation and restoration of normoglycemia as the optimal clinical goal. The transition from normoglycemia through increasing dysglycemia to T2D is progressive and cumulatively shaped by biological, behavioral and environmental exposures across the life course. Prediabetes (intermediate hyperglycemia) remission is an achievable, pragmatic and measurable prevention target. Here we provide a life-course risk architecture for T2D integrating developmental, transitional and contextual determinants, defining critical windows of amplified metabolic vulnerability and potential restoration of normoglycemia. Precision prevention should target mechanistic heterogeneity, with aligned interventions that remain scalable, affordable and adaptable across socioeconomic settings. Our framework identifies ten priorities in T2D prevention, moving beyond traditional approaches toward context-specific, actionable interventions capable of altering the natural history of disease early in the life course and restoring metabolic health.
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Publication type Article: Journal article
Document type Review
Keywords Prediabetes ; Psychological Intervention ; Type 2 Diabetes ; Life Course Approach ; Vulnerability (computing) ; Type 2 Diabetes Mellitus ; Disease; Impaired Glucose-tolerance; Hormone-binding Globulin; Insulin-resistance; Style Intervention; Double-blind; Intrauterine Exposure; Precision Medicine; Cost-effectiveness; Sex-hormones; Risk
ISSN (print) / ISBN 1078-8956
e-ISSN 1546-170X
Journal Nature medicine
Quellenangaben Volume: 32, Issue: 8, Pages: 2757-2773 Article Number: , Supplement: ,
Publisher Nature Publishing Group
Publishing Place New York, NY
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Institute of Experimental Genetics (IEG)
Computational Health Center (CHC)
Grants German Research Foundation
China Scholarship Council at the Medical Faculty of the University of Tbingen
Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases within the National Institutes of Health (NIH)
Helmholtz Munich
Ministry of Science, Research and the Arts Baden-Wrttemberg
German Center for Diabetes Research via the German Federal Ministry of Research, Technology and Space