Life’s essential 8 and risk of progression to diabetes among young adults with prediabetes

TL;DR

This study shows that maintaining good cardiovascular health can significantly reduce the risk of prediabetes progressing to diabetes in young adults.

Contribution

The study links Life’s Essential 8 health metrics to diabetes progression risk in young adults with prediabetes.

Findings

34% of prediabetic young adults progressed to diabetes over 13 years.

Ideal Life’s Essential 8 scores were associated with a 40–90% lower risk of diabetes progression.

Progression to diabetes was linked to the greatest decline in cardiovascular health scores.

Abstract

The aim of the study was to assess Life’s Essential 8 (LE8) trajectories by glycemic status change and examine their association with diabetes progression risk in young adults with prediabetes (preDM). We used the Coronary Artery Risk Development in Young Adults study (CARDIA) Year 7–30 data to estimate trends of LE8 scores among preDM participants (impaired fasting glucose, impaired oral glucose tolerance, and/or HbA1c 5.7–6.4%) by status of progression, consistent preDM, and regression. We used logistic regression to evaluate the progression risk with LE8. Among 974 preDM participants, 34% progressed to diabetes, 28% remained preDM, and 38% regressed to euglycemia. Over a mean follow-up of 13 years, the progression group had the greatest decline in LE8 scores. Ideal LE8 scores (vs. moderate or poor) were associated with a 40–90% reduction in the progression risk. In conclusion, maintaining optimal cardiovascular health may prevent diabetes progression among young adults with preDM.

The online version contains supplementary material available at 10.1038/s41598-025-19472-y.

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