Prediabetes as a Therapeutic Target

Abstract

BACKGROUND The term “prediabetes” is used to describe a condition that involves impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). IGT is defined by a 2-h oral glucose tolerance test plasma glucose concentration >140 mg/dL (7.8 mmol/L) but <200 mg/dL (11.1 mmol/L), and IFG is defined by a fasting plasma glucose concentration ≥100 mg/dL (5.6 mmol/L), but <126 mg/dL (7.0 mmol/L). Studies have shown that people with prediabetes tend to develop type 2 diabetes within 10 years and are at increased risk for cardiovascular disease and death even before the development of diabetes. CONTENT In this minireview we discusses the epidemiology, pathophysiology, and clinical implications of prediabetes. The rationale for therapeutic intervention in people with prediabetes, the goals of intervention, and the specific tools for intervention are presented. Emphasis is placed on data from randomized controlled clinical trials, whenever such data are available. SUMMARY Approximately 57 million Americans have prediabetes and are consequently at risk for cardiometabolic complications. Lifestyle modifications (dietary restriction and exercise) and certain medications can prevent the development of diabetes in persons with prediabetes. Lifestyle intervention also has been demonstrated to decrease cardiovascular disease risk markers, although data on clinical events are lacking.

Hormetic and regulatory effects of lipid peroxidation mediators in pancreatic beta cells

“…Often such individuals subjected to these tests exhibit impaired glucose tolerance. Similarly, increased levels of glycosylated hemoglobin (A1C) indicate whether a patient is diabetes-prone albeit fasting blood glucose levels that appear normal or moderately increased (Buysschaert and Bergman, 2011;Fonseca, 2007;Pour and Dagogo-Jack, 2011).…”

Derivation and validation of an HbA1c optimal cutoff for diagnosing prediabetes in a South African mixed ancestry population

“…In developing countries, a 69% increase is expected in the next two decades amongst adults compared to a 20% increase in developed countries [1]. Most people with diabetes go through a prediabetic phase for several years during which there is an opportunity to identify them and institute preventative measures [2,3]. The concept of an intermediate state between normoglycaemia and diabetes was first introduced in 1979 by the National Diabetes Data Group.…”

Skeletal Muscle Mitochondrial Function/Dysfunction and Type 2 Diabetes

“…The term "prediabetes" is used to describe a condition characterized by impaired glucose tolerance or impaired fasting glucose (Pour and Dagogo-Jack, 2011). The pathophysiology of prediabetes is characterized by alterations in insulin sensitivity and pancreatic beta-cell function, usually associated with increased adiposity (Dagogo-Jack et al, 2009).…”