Define prediabetes
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Understanding Prediabetes: Definition, Risks, and Implications
Definition of Prediabetes
Prediabetes is a condition characterized by blood glucose levels that are higher than normal but not yet high enough to be classified as diabetes. This intermediate state, also known as intermediate hyperglycemia, is defined by specific glycemic thresholds that vary slightly depending on the criteria used. The American Diabetes Association (ADA) defines prediabetes as having impaired fasting glucose (IFG) with fasting glucose levels between 5.6-6.9 mmol/L, impaired glucose tolerance (IGT) with 2-hour plasma glucose levels between 7.8-11.0 mmol/L during an oral glucose tolerance test, or raised hemoglobin A1c (HbA1c) levels between 5.7-6.4%1 2 3.
Prevalence and Global Impact
The prevalence of prediabetes is increasing worldwide, with projections indicating that more than 470 million people will have prediabetes by 2030. This rise is attributed to lifestyle changes, including increased access to high-calorie foods and decreased physical activity, leading to higher rates of obesity and metabolic disorders1 7.
Pathophysiology and Risk Factors
Prediabetes is associated with insulin resistance and β-cell dysfunction, which occur before detectable changes in glucose levels. This condition is also linked to various metabolic abnormalities such as dyslipidemia, hypertension, and obesity. These factors collectively increase the risk of developing type 2 diabetes (T2D) and other complications1 6 8.
Health Risks Associated with Prediabetes
Individuals with prediabetes are at an increased risk of developing several health issues, including:
- Type 2 Diabetes: Approximately 5-10% of people with prediabetes progress to diabetes each year1.
- Cardiovascular Disease: Prediabetes is associated with a higher risk of cardiovascular events, including coronary heart disease and stroke. The relative risk of cardiovascular disease increases with higher fasting glucose and HbA1c levels2 9.
- Microvascular Complications: Early forms of nephropathy, chronic kidney disease, small fiber neuropathy, and diabetic retinopathy can manifest in individuals with prediabetes1 6 8.
- All-Cause Mortality: There is an increased risk of all-cause mortality in individuals with prediabetes compared to those with normoglycemia2 9.
Interventions and Prevention
Lifestyle modification is the cornerstone of preventing the progression from prediabetes to diabetes. Interventions such as dietary changes, increased physical activity, and behavioral weight loss strategies have shown significant improvements in weight and glycemic control, reducing the incidence of diabetes by 40-70%1 10. Pharmacotherapy, including the use of metformin, has also demonstrated potential benefits in managing prediabetes1.
Conclusion
Prediabetes is a critical health condition that serves as a precursor to type 2 diabetes and is associated with various metabolic and cardiovascular risks. Understanding its definition, prevalence, and associated health risks is essential for implementing effective prevention strategies. Lifestyle modifications and, in some cases, pharmacotherapy can significantly reduce the risk of progression to diabetes and improve overall health outcomes.
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Most relevant research papers on this topic
Prediabetes: a high-risk state for diabetes development
Prediabetes is a high-risk state for diabetes development, and lifestyle modification and pharmacotherapy can significantly reduce the risk of developing diabetes.
Rigorous Journal
Highly CitedAssociation between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis
Prediabetes, defined as impaired glucose tolerance, impaired fasting glucose, or raised HbA1c, is associated with an increased risk of cardiovascular disease and all cause mortality.
Meta-AnalysisRigorous JournalHighly CitedPrevalence of Pre-Diabetes across Ethnicities: A Review of Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) for Classification of Dysglycaemia
Impaired fasting glucose prevalence is higher in Caucasian populations, while impaired glucose tolerance and combined IFG&IGT prevalence are higher in Asian populations.
Systematic Review
Very Rigorous JournalHighly CitedPre-Diabetes and What It Means: The Epidemiological Evidence.
Establishing consensus definitions for prediabetes is crucial for cost-effective treatment and prevention of diabetes, cardiovascular risk factors, and death, while improving current screening and diagnostic practices.
Highly CitedDefinition of prediabetes.
The current definition of prediabetes may underestimate the implications and vastness of this disorder, and research should focus on these aspects to minimize the risk of developing a preventable condition.
Highly CitedPrediabetes and Cardiovascular Disease: Pathophysiology and Interventions for Prevention and Risk Reduction.
Prediabetes can lead to long-term complications like microvascular and macrovascular disorders, and interventions can help prevent progression to type 2 diabetes and reduce macrovascular risk.
Highly CitedPrediabetes: A Worldwide Epidemic.
Prediabetes is a worldwide epidemic due to increased access to high-calorie food and decreased physical activity, increasing the risk of developing type 2 diabetes mellitus and other complications.
Highly CitedHealth risks and interventions in prediabetes: A review.
Prediabetes is a condition with multiple risk factors and health issues, and interventions can help prevent the development of diabetes and its complications.
Literature ReviewAssociation between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis
Prediabetes is associated with an increased risk of all cause mortality and cardiovascular disease, particularly in individuals with atherosclerotic cardiovascular disease.
Meta-AnalysisRigorous JournalHighly CitedLong-term non-pharmacological weight loss interventions for adults with prediabetes.
Weight loss strategies using dietary, physical activity, or behavioral interventions significantly improved weight and decreased diabetes incidence in adults with prediabetes.
Systematic ReviewHighly Cited