Prediabetes: a high-risk state for diabetes development

Abstract

Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 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 of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy.

Association of subclinical inflammation with deterioration of glycaemia before the diagnosis of type 2 diabetes: the KORA S4/F4 study

“…Our data indicate that inflammationrelated processes, which are mainly independent of adiposity, also affect the deterioration of glycaemia before the diagnosis of type 2 diabetes. Considering these results in the context of studies on increased risk of macro-and microvascular comorbidities of prediabetes [9], our data furthermore suggest that interventions that attenuate subclinical inflammation in prediabetes may have clinical benefit and deserve more attention in the future.…”

“…However, most studies that have investigated subclinical inflammation in the context of type 2 diabetes have focused on the incidence of diabetes as outcome, whereas little is known about the role of proinflammatory processes such as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) in the early stages of dysglycaemia; together, these processes are termed 'prediabetes' [9].…”

“…A better understanding of subclinical inflammation in prediabetes is important because (1) prediabetes is highly prevalent in most adult populations worldwide [10][11][12]; and (2) individuals with prediabetes have a moderately increased risk of macrovascular and microvascular complications [9] which were both previously considered diabetic complications in the later stages of the disease.…”

Physical Activity and Abnormal Blood Glucose Among Healthy Weight Adults

“…4 Second, there is an equal or more important need to detect prediabetes, a state of abnormal blood glucose that indicates high risk for the development of Type 2 diabetes. 5 Strategies for detection of abnormal glucose tend to focus on individuals who are overweight or obese. 4,6 Recent data have indicated, however, that a substantial proportion of individuals at a "healthy weight" (BMI between 18.5 and 24.9) have prediabetes.…”

The Hypoglycaemic Potential of Antioxidant-Rich Food Extracts

“…However, factors such as poor diet, lack of physical activity and excessive weight all contribute to a prediabetic state where control of glucose and insulin become impaired [3]. Current studies suggest that the prevalence of prediabetes is increasing worldwide, and it is expected that the number of affected individuals will reach >470 million in 2030 [3]. The World Health organisation recognises the risk associated with being prediabetic, stating that these individuals are at "high-risk of developing diabetes" [47].…”