Interventions Targeting Impaired Fasting Glucose: A Comprehensive Review of Strategies to Prevent Type 2 Diabetes

Objective: Impaired Fasting Glucose (IFG), a state of prediabetes characterized by elevated fasting glucose levels, signifies a significantly increased risk of developing Type 2 Diabetes Mellitus (T2D) and associated cardiovascular complications. This comprehensive review systematically analyzes evidence from original research, including Randomized Controlled Trials (RCTs), prospective and retrospective cohort studies, and single- and multi-center implementation experiences, to evaluate the effectiveness and translation challenges of interventions targeting IFG progression. Methods: A targeted literature search was conducted across major medical databases, focusing on human intervention studies published between 2000 and 2025. Included articles were categorized based on intervention type (Intensive Lifestyle Intervention ILI or pharmacological) and study design, with an emphasis on T2D incidence rate reduction as the primary outcome. Key Findings: The analysis confirms that ILI, focused on diet, physical activity, and achieving moderate weight loss (5–7%), remains the most efficacious long-term strategy, demonstrating superior and sustained T2D risk reduction (e.g., 58% in the Diabetes Prevention Program) (Diabetes Prevention Program Research Group, 2002); (Tuomilehto et al., 2001). Metformin therapy serves as a critical, cost-effective pharmacological alternative, particularly for high-risk subgroups (e.g., younger individuals, high BMI). Translational studies, including retrospective and multi-center experiences, highlight significant barriers to real-world implementation, such as low sustained adherence and scalability challenges within diverse populations. Conclusion: Effective T2D prevention in individuals with IFG necessitates early, risk-stratified intervention. While ILI is the gold standard, future strategies must focus on developing tailored, technologically-supported, and scalable programs to overcome implementation barriers and maximize population-level health impact.