[Glycemic control and cardiovascular health in prediabetes: untiring exploration towards consensus]

Diabetes-related cardiovascular diseases carry high rates of disability and mortality, and their medical costs are prohibitively expensive. Shifting management upstream is imperative. The risk of cardiovascular and cerebrovascular diseases in diabetic populations exists prior to the onset of diabetes. Can lifestyle interventions targeting the prevention of diabetes in people with pre-diabetes also extend to reducing cardiovascular risk? The Daqing Diabetes Prevention Study (DQDPOS) in China provided a definitive answer, though regrettably, this was not corroborated by comparable studies in the United States. Consequently, this has prevented the cardiovascular and diabetes communities from reaching consensus regarding early intervention strategies for cardiovascular disease. By 2024, the European Cardiovascular Community still did not include prediabetes in its cardiovascular disease management population. By late 2025, two landmark studies from China and the United States of America (DQDPOS and DPPOS) reported that individuals with prediabetes who achieved normal blood glucose levels experienced a substantial reduction in the risk of heart failure and cardiovascular mortality compared to those who did not normalize plasma glucose levels. It is hoped this new finding will spur the cardiovascular community to develop more proactive strategies for intensifying glycaemia control in prediabetic populations to reduce cardiovascular risk. Given the prediabetic population in China exceeding 300 million, effective cardiovascular risk management in this population would benefit the reduction of cardiovascular risk across the entire population.