Prediabetes: a high-risk state for diabetes development.
Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy.
Department of Epidemiology and Public Health, University College London, London, UK. a.tabak@ucl.ac.uk
Adam G
AG
Tabák
Christian
C
Herder
Wolfgang
W
Rathmann
Eric J
EJ
Brunner
Mika
M
Kivimäki
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000517:prevention & control; D018450:Disease Progression; D014943:Global Health; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008833:Microcirculation; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D040242:Risk Reduction Behavior
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents