title: Approaching pre-diabetes.
abstract: As the global epidemic of type 2 diabetes continues to rise, the time has come to revisit our approach to pre-diabetes. Recently, much ado has been made about screening, diagnosis, pathophysiology and clinical interventions in pre-diabetes, and all for good reason as the key to reversing the diabetes epidemic likely lies therein. The somewhat controversial term "pre-diabetes" represents collective dysglycemic states intermediate between normal glucose regulation (NGR) and diabetes. Not all people with pre-diabetes will develop diabetes, but the majority will. In fact, up to 70% of those with pre-diabetes may acquire the disease over their lifetime. Furthermore, even when overt diabetes is delayed or prevented, both micro- and macrovascular disease appears more prevalent in those with pre-diabetes compared to their normoglycemic peers. Hence, there is growing consensus that NGR should be the goal for people with pre-diabetes. Nevertheless, there is much to consider in that pursuit. Herein, we provide an update on the global burden of pre-diabetes, its underlying pathophysiology and discuss clinical considerations in these individuals at high risk of developing diabetes.
authors.affiliation: University of Colorado Anschutz Medical Center, Aurora, CO, USA. Electronic address: Leigh.perreault@ucdenver.edu.
authors.forename: Leigh
authors.initials: L
authors.lastname: Perreault
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark.
authors.forename: Kristine
authors.initials: K
authors.lastname: Færch
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening; D011236:Prediabetic State / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors
keywords: Impaired fasting glucose; Impaired glucose tolerance