Introduction and Objective: This study aimed to compare the effectiveness of the Korean Diabetes Prevention Study (KDPS) and the Korean Genome and Epidemiology Study (KoGES) in preventing diabetes among prediabetes populations. The primary focus was to evaluate the outcomes of different intervention strategies and their impact on diabetes progression. Methods: KDPS employed three intervention strategies: Standard Management (STM) with biannual education; Lifestyle Modification (LSM) with an intensive 6-month program followed by quarterly follow-ups; and Metformin (MET) therapy with up to 1000 mg doses and quarterly visits. KoGES, a prospective nationwide cohort study, investigates genetic and environmental factors in chronic diseases. Participants included individuals with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or HbA1c levels between 5.7-6.4%. Propensity score matching (PSM) standardized baseline characteristics, and Kaplan-Meier survival analysis compared diabetes progression over time. Results: After PSM, baseline characteristics were balanced between KDPS (n=350) and KoGES (n=350) participants. Over a follow-up period of 6 years, the cumulative incidence of diabetes in the KDPS cohort was 63 cases, significantly lower than the 147 cases observed in the KoGES cohort (p<0.01). Survival analysis revealed meaningful differences in survival rates between the two cohorts, providing important insights into strategies for diabetes prevention and management. Conclusion: The findings demonstrate that targeted interventions in the KDPS cohort effectively reduce diabetes incidence compared to the general population represented by KoGES. This study underscores the importance of structured prevention programs in mitigating diabetes risk and provides a robust framework for future comparative analyses. Disclosure S. Yun: None. H. Sang: None. S. Shin: None. J. Choi: None. Y. Yoon: None. S. Chon: None. J. Woo: None.