Prediabetes and its complex spectrum as a challenge to daily clinical practice

Abstract

Prediabetes is recognised  as  an  important metabolic state; as well as an individual predisposing  factor to  a high  probability  of future  progression  to  diabetes,  individuals with prediabetes  are at increased  risk of developing  many  of  the  pathologies  associated  with that  disease,  such  as  diabetic  retinopathy, neuropathy, nephropathy and macrovascular complications. The risk for T2DM in prediabetic subjects is higher compared with those with normal glucose tolerance (NGT). In the subjects who were diagnosed with IFG and IGT in combination, the annual percentage for the risk of developing T2DM increased by 10%. This suggests that IFG and IGT have additive roles in predicting the risk of developing T2DM.  The occurrence of cardiovascular disease and associated mortality in prediabetic subjects compared with NGT are known to be significantly elevated in nearly over 50%.  Because of the progression to T2DM, ACVD or micro or macrovascular complications can be prevented, the clinical approach must invest more time to develop a systematic approach, so individual management is required given the observed significant pathophysiological heterogeneity in this condition.  The purpose of this revision is to update current definitions about this condition which may pass unnoticed by many medical doctors, and which we must consider as an important risk factor for T2DM and CVD.