Fewer new cases of type 2 diabetes
- Published in
- Ann Intern Med 2025
- People studied
- 4,746
In a Spanish trial of 4,746 adults aged 55 to 75, a lower-calorie Mediterranean diet with more activity went with 31% fewer new cases of type 2 diabetes over about 6 years.
- Checked against
- PubMed 40854218
- Published in
- Ann Intern Med 2025
- Last checked
- 30 October 2026
Key takeaway
PREDIMED-Plus included 4,746 adults aged 55 to 75 in Spain with overweight or obesity and metabolic syndrome, a cluster of heart risk factors, but no diabetes. They were randomly assigned to a Mediterranean diet with a planned 600 fewer calories a day, more activity and support to lose weight, or to Mediterranean diet advice with no calorie limit. Over a median of 6 years, 9.5% of the programme group developed type 2 diabetes, against 12.0% of the comparison group, a 31% lower rate. The programme group also lost more weight and more off their waist.
At a glance
- Type of study
- randomised trial (PREDIMED-Plus), a planned secondary outcome, not the main one
- People studied
- 4,746
- How long
- about 6 years (median)
- Compared with
- people given Mediterranean diet advice with no calorie limit
- Main result
- 31% fewer new cases of type 2 diabetes over about 6 years.
- Strength of evidence
- Randomised trials
What this study does not show
Diabetes was a planned secondary outcome, not the trial's main question. The comparison group also ate a Mediterranean diet, so this shows the added effect of fewer calories, activity and modest weight loss. The abstract does not say how much weight was lost, and only adults aged 55 to 75 with metabolic syndrome took part.
Results from studies in groups of people, mostly in diet and movement programmes. They cannot be promised to any one person. This information is educational and does not replace a consultation with a doctor.
More on metabolism
- Lower diabetes risk with each kiloLong-term or observational studies · Hamman et al., Diabetes Care 2006
- Better insulin responseSmall or uncontrolled studies · Magkos et al., Cell Metab 2016
- Half as many new diabetes casesRandomised trials · Tuomilehto et al., NEJM 2001
- More than 5% for clearer blood sugar gainsRandomised trials · Franz et al., J Acad Nutr Diet 2015
- More diabetes remission with fewer caloriesRandomised trials · Jayedi et al., Am J Clin Nutr 2023
- Remission of type 2 diabetes at 2 yearsRandomised trials · Lean et al., Lancet Diabetes Endocrinol 2019
- Fewer new cases of type 2 diabetesRandomised trials · Ruiz-Canela et al., Ann Intern Med 2025
The next step is a conversation, not a decision
A licensed doctor decides whether any treatment is right for you. The answer can also be no treatment.
1You fill in a short form
2We call you within 24 hours
3A paid 20-minute video consultation with a doctor
4The doctor goes through your options and decides what is right for you