Eating healthy foods, losing weight, and moving more can lower the chance of getting type‑2 diabetes. But not everyone gets the same level of protection.
Scientists from the German Center for Diabetes Research, the University Hospital Tübingen, and Helmholtz Munich studied a group of people called “cluster 5.” Even after these participants lost a lot of weight and kept it off for years, their blood‑sugar kept rising, their bodies made less insulin, and their risk of diabetes stayed high.
Earlier, researchers sorted people at risk for type‑2 diabetes into six clear groups. Each group showed different chances of getting diabetes and different patterns of complications.
Groups 3 and 5 were known to have the highest chances of developing diabetes. The new study asked whether long‑term weight loss worked the same way for all groups.
Cluster 5 Stayed at Risk Even After Weight Loss
The team looked at data from the Tübingen Lifestyle Intervention Program (TULIP). Participants joined a two‑year plan that changed diet and activity, then were followed for about nine more years.
They focused on people who lost a lot of weight and kept it off for a long time.
Fatty Liver and Insulin Resistance May Explain the Problem
Researchers also wanted to know why lifestyle changes helped other groups more than cluster 5. They found that insulin resistance played a big role, likely linked to severe fatty liver disease.
When fat builds up in the liver, it can hurt the pancreas’s ability to release insulin, causing higher blood‑sugar levels. This combination makes people in cluster 5 especially vulnerable to both diabetes and heart disease.
One‑Size‑Fits‑All Prevention Might Not Work
The study suggests that people in cluster 5 do not get the same metabolic benefits from weight loss as others, even when they lose and keep off a lot of weight.
If future research confirms these findings, diabetes prevention may need to be tailored. High‑risk individuals like those in cluster 5 might need extra care or special treatments that target their specific metabolic issues.