New Sub-Phenotyping of Subjects at High Risk of Type 2 Diabetes: What Are the Potential Clinical Implications?

Abstract

Prediabetes is defined as a condition of abnormal glucose metabolism, characterised by plasma glucose above normal range but not as high as required for the diagnosis of diabetes mellitus (DM). It represents a heterogeneous entity of intermediate glucose metabolism, including impaired fasting glucose, impaired glucose tolerance, and borderline glycated haemoglobin. Prediabetes is being increasingly recognised as an important metabolic state not only predisposing to a higher probability of future progression to DM, but also to an increased risk of different micro- and macrovascular complications. The recently proposed sub-phenotyping of individuals at increased risk of type 2 DM, which distinguishes six different clusters, offers the opportunity for the improvement in screening, prevention, and treatment algorithms. Such progress should also enable more efficient and cost-effective strategies aimed at decreasing the disease burden associated with prediabetes.

Bioengineered Pancreas–Liver Crosstalk in a Microfluidic Coculture Chip Identifies Human Metabolic Response Signatures in Prediabetic Hyperglycemia

“…Prediabetes is associated with pathological alterations in various tissues, including pancreas, and liver, and is commonly defined as intermediate hyperglycemia following an oral glucose tolerance test. [ 8 , 9 ] However, while prediabetes constitutes one of the most predictive risk factors for T2DM with annual conversion rates of 5–20%, [ 10 ] this early stage of metabolic disturbances has received comparably little attention.…”

Prediabetes and Cardiometabolic Risk: The Need for Improved Diagnostic Strategies and Treatment to Prevent Diabetes and Cardiovascular Disease

“…The genetic characteristics associated with the groups differed from the traditional classification. In general, this report represented an important first step towards precision medicine in diabetes [61,62].…”

Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Obesity/Metabolic Syndrome, Prediabetes/Diabetes and Non-Alcoholic Fatty Liver Disease—Current Evidence

“…All GLP-1 RA class agents have proven efficacy in both, glucose control and concurrent clinically relevant BW reduction in patients with T2DM. 131 However, patients with T2DM have more difficulty in losing BW compared with individuals without DM, 132 and the mean BW loss difference between GLP-1 RAs and placebo in patients with and without DM was 4% to 6.2% versus 6.1% to 17.4%, respectively. 132 Trujillo et al 133 rated the drug members according to BW lowering potency in the following order: semaglutide > liraglutide > dulaglutide > exenatide extended-release ¼ exenatide (twice daily) ¼ lixisenatide.…”

“…All GLP-1 RA class agents have proven efficacy in both, glucose control and concurrent clinically relevant BW reduction in patients with T2DM. 131 However, patients with T2DM have more difficulty in losing BW compared with individuals without DM, 132 and the mean BW loss difference between GLP-1 RAs and placebo in patients with and without DM was 4% to 6.2% versus 6.1% to 17.4%, respectively. 132…”