Anti-inflammatory diets for prediabetes remission: a mechanistic and practical roadmap

Prediabetes affects a significant portion of the global population. Shifting the clinical paradigm from delaying type 2 diabetes (T2D) to actively achieving remission offers a transformative opportunity. This perspective article posits that anti-inflammatory dietary patterns are a cornerstone strategy for prediabetes remission. We explore the mechanistic pathways through which diet-driven inflammation modulates glycemic control and argue for the adoption of the Dietary Inflammatory Index (DII) as a practical, integrative metric to guide dietary choices. By synthesizing evidence from major clinical trials and aligning with the recently released 2025-2030 Dietary Guidelines for Americans, we propose a scalable implementation framework. This article presents our position that remission should be treated as a distinct clinical endpoint, with diet quality, specifically its inflammatory potential, serving as a key modifiable target. We discuss the scientific rationale, propose practical tools for clinical application, and critically acknowledge the limitations of the current evidence base, emphasizing the need for future research to refine and personalize this approach.