Journal of Diabetes and Its Complications · Jan 29, 2026

The association between reversion of prediabetes and incident cardiometabolic disease and mortality: A systematic review and meta-analysis

By Liu H, He J, Gao Y et al.

AIMS: Evidence on the relationship between reversion of prediabetes and the risk of incident cardiometabolic disease and mortality remains inconsistent. Our study aimed to investigate the association between reversion of prediabetes and the risk of incident cardiometabolic disease and mortality. METHODS: A systematic research was performed in three databases up to September 2024. Two reviewers independently identified cohort studies that reported the association between reversion of prediabetes with incident cardiometabolic disease and mortality. The PRISMA guideline was followed, and study eligibility and data extraction were each reviewed independently by two authors. Random-effects meta-analyses were used to estimate the pooled effects. RESULTS: Our systematic review included 18 studies, 12 of which were eligible for meta-analysis, comprising a total of 535,066 participants. Compared with participants who had persistent prediabetes, those who reversed from prediabetes to normoglycemia had a 68% lower risk of incident diabetes (HR: 0.32; 95% CI: 0.25, 0.43). There were no significant differences in risk of incident cardiovascular disease (HR: 0.98; 95% CI: 0.94, 1.02), CVD mortality (HR: 0.84; 95% CI: 0.65, 1.10), and all-cause mortality (HR: 0.97; 95% CI: 0.92, 1.02) between those who reversed to normoglycemia and those who had persistent prediabetes. By contrast, compared with individuals who progressed from prediabetes to diabetes, those who reversed from prediabetes to normoglycemia had a lower risk of CVD (HR: 0.75; 95% CI: 0.63, 0.88). CONCLUSION: Reversion of prediabetes could significantly reduce the risk of diabetes. However, the evidence regarding its impact on CVD and mortality remained inconclusive, with some benefits observed when compared to individuals who progress to diabetes. TRIAL REGISTRATION: PROSPERO: CRD42024582540.

doi.org/10.1016/j.jdiacomp.2026.109272PubMed 41881867Populations