Condition evidence map
Prediabetes
Research evidence map for prediabetes (impaired fasting glucose, impaired glucose tolerance, HbA1c in the prediabetic range) and the role of incretin medicines in preventing or delaying progression to type 2 diabetes.
Research context
Prediabetes is the intermediate hyperglycaemic state preceding T2D. Trial data from SCALE Obesity and Prediabetes (liraglutide), the STEP programme (semaglutide) and SURMOUNT (tirzepatide) include prediabetic subsets where reversion to normoglycaemia is reported alongside the primary weight or glycaemic endpoint.
Why this matters metabolically
Progression from prediabetes to T2D is associated with substantial downstream cardiometabolic and microvascular risk. Pharmacological reversion of prediabetes to normoglycaemia — even temporarily — has been an interest of incretin research for over a decade.
FAQs
- Can GLP-1 receptor agonists prevent type 2 diabetes?
- Subgroup analyses of pivotal weight-management trials report higher rates of reversion from prediabetes to normoglycaemia in active arms versus placebo. Whether this constitutes durable prevention of T2D, rather than temporary suppression during therapy, is an active research question.
- Trial-reported reversion to normoglycaemia in a defined cohort does not establish individual suitability.
- Short-term glycaemic improvement does not necessarily prevent long-term T2D progression after discontinuation.
- Prediabetes itself is not a UK-licensed indication for incretin therapy.
Related mechanisms
Related peptide profiles
Related trials
Related safety signals
Related conditions
Sources are tagged by class. Regulatory documents, peer-reviewed publications and trial registry records are preferred. Manufacturer disclosures and conference material are accepted where peer-reviewed publication is not yet available; preprints are flagged.
- Peer-reviewed publicationPi-Sunyer X et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management (SCALE Obesity and Prediabetes). N Engl J Med 2015.
- Peer-reviewed publicationWilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021.
- Regulatory document (MHRA/EMA/FDA)MHRA — Medicines and Healthcare products Regulatory Agency
UK regulatory authority for medicines and medical devices
- Regulatory document (MHRA/EMA/FDA)NICE — National Institute for Health and Care Excellence
NICE guidance on treatment pathways for metabolic conditions
- Editorial synthesisSite editorial synthesis — Metabolic Peptides
Editorial summary of condition profiles on this site