title: Update on pre-diabetes: Focus on diagnostic criteria and cardiovascular risk.
abstract: Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than the diabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose (IFG), those with impaired glucose tolerance (IGT) and those with a glycated haemoglobin (HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c-pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1cis scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and current controversies in the field. In consideration of the expected increased use of HbA1cas a screening tool to identify individuals with alteration of glycaemic homeostasis, we focused on the evidence regarding the ability of HbA1cas a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.
authors: Antonino Di Pino, Francesca Urbano, Salvatore Piro, Francesco Purrello, Agata Maria Rabuazzo, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
authors: Antonino
authors: A
authors: Di Pino
authors: Antonino Di Pino, Francesca Urbano, Salvatore Piro, Francesco Purrello, Agata Maria Rabuazzo, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
authors: Francesca
authors: F
authors: Urbano
authors: Antonino Di Pino, Francesca Urbano, Salvatore Piro, Francesco Purrello, Agata Maria Rabuazzo, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
authors: Salvatore
authors: S
authors: Piro
authors: Antonino Di Pino, Francesca Urbano, Salvatore Piro, Francesco Purrello, Agata Maria Rabuazzo, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
authors: Francesco
authors: F
authors: Purrello
authors: Antonino Di Pino, Francesca Urbano, Salvatore Piro, Francesco Purrello, Agata Maria Rabuazzo, Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy.
authors: Agata Maria
authors: AM
authors: Rabuazzo
keywords: Cardiovascular risk; Diagnostic criteria; Glycated haemoglobin; Non-traditional glycaemic markers; Pre-diabetes