From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research

Abstract

Diabetes, a silent killer, is one of the most widely prevalent conditions of the present time. According to the 2017 International Diabetes Federation (IDF) statistics, the global prevalence of diabetes among the age group of 20–79 years is 8.8%. In addition, 1 in every 2 persons is unaware of the condition. This unawareness and ignorance lead to further complications. Pre-diabetes is the preceding condition of diabetes, and in most of the cases, this ultimately leads to the development of diabetes. Diabetes can be classified into three types, namely type 1 diabetes, type 2 diabetes mellitus (T2DM) and gestational diabetes. The diagnosis of both pre-diabetes and diabetes is based on glucose criteria; the common modalities used are fasting plasma glucose (FPG) test and oral glucose tolerance test (OGTT). A glucometer is commonly used by diabetic patients to measure blood glucose levels with fast and rather accurate measurements. A few of the more advanced and minimally invasive modalities include the glucose-sensing patch, SwEatch, eyeglass biosensor, breath analysis, etc. Despite a considerable amount of data being collected and analyzed regarding diabetes, the actual molecular mechanism of developing type 2 diabetes mellitus (T2DM) is still unknown. Both genetic and epigenetic factors are associated with T2DM. The complications of diabetes can predominantly be classified into two categories: microvascular and macrovascular. Retinopathy, nephropathy, and neuropathy are grouped under microvascular complications, whereas stroke, cardiovascular disease, and peripheral artery disease (PAD) belong to macrovascular complications. Unfortunately, until now, no complete cure for diabetes has been found. However, the treatment of pre-diabetes has shown significant success in preventing the further progression of diabetes. To prevent pre-diabetes from developing into T2DM, lifestyle intervention has been found to be very promising. Various aspects of diabetes, including the aforementioned topics, have been reviewed in this paper.

The Role of Inflammation in Diabetic Retinopathy

“…In the case of diabetic retinopathy (DR), clinical signs manifest some time (often years) after the onset of diabetes; however, in T2D DR paradoxically may be the presenting sign, with the implication that an underlying diabetic state has been present but clinically "silent" for years. In fact, it is estimated that for every known case of T2D there is another undiagnosed (39,40). The prolonged time for development of complications has been incorporated into a notion of "metabolic memory" but recent analysis has poured cold water on this idea and ascribes the risk of complications to a cumulative exposure to high glucose levels (41).…”

Synbiotic kefir lowered peroxisome proliferator activated receptor gamma (PPARγ) gene expression in rat fed high-fat and high-fructose diet

“…The HFHF diet in this study had not yet led to diabetes, but only causes prediabetes because blood glucose levels range from 100 mg / dL to 125 mg / dL, which is at risk of becoming diabetic (> 126 mg/dL), whereas the normal blood glucose was < 100 mg/dL (Gholi et al, 2016;Khan et al, 2019).…”

Abscisic Acid Treatment in Patients with Prediabetes

“…Several trials showed that one of most promising approaches to achieve this goal is a comprehensive lifestyle change consisting of diet, physical activity and weight loss [ 6 ], that, ameliorating β-cell function and insulin sensitivity, can contribute to prevent the onset of diabetes [ 7 ]. Although lifestyle intervention is often difficult to implement and maintain in the long-term because of poor adherence by patients [ 8 , 9 ], it represents the primary tool for prevention of T2DM development from prediabetes due to its efficacy, safety and cost-effectiveness [ 6 ].…”