What is prediabetes?
Prediabetes can be divided into two biochemical and pathophysiological states - impaired glucose tolerance and impaired fasting glucose.
Both impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are pre-diabetic states. IGT was defined as having normal fasting plasma glucose (< 6.1 mmol/l) and abnormal 2-hr post-challenge plasma glucose. IFG was defined as having abnormal fasting plasma and normal 2-hr post-challenge plasma glucose (< 7.8 mmol/l).
Global data from the IDF show an increased incidence of impaired glucose tolerance. In 2019, 7.5% of the world's total population between the ages of 20 and 79 were diagnosed with this condition. Most of these people (72.2%) live in low- or middle-income countries. The number of adults aged 20 to 79 is projected to increase to 453.8 million people, or 8% of the world's adult population, by 2045.
Why Is Identifying and Managing Prediabetes Important?
1
Higher risk of developing type 2 diabetes
Individuals with both impaired glucose tolerance and elevated fasting glucose levels have a higher risk of developing diabetes compared to those with only one condition.
The U.S. Diabetes Prevention Program has demonstrated that approximately 10% of people with impaired glucose tolerance develop diabetes on an annual basis.
A pooled analysis of two diabetes prevention studies in India found that the incidence of type 2 diabetes in subjects with both IGT and IFG was 56% compared to 34% in subjects with isolated IGT. Evidence suggests that approximately 70% of individuals with untreated IFG and/or IGT end up developing type 2 diabetes.
Individuals with both impaired glucose tolerance and elevated fasting glucose levels have a higher risk of developing diabetes compared to those with only one condition.
The U.S. Diabetes Prevention Program has demonstrated that approximately 10% of people with impaired glucose tolerance develop diabetes on an annual basis.
A pooled analysis of two diabetes prevention studies in India found that the incidence of type 2 diabetes in subjects with both IGT and IFG was 56% compared to 34% in subjects with isolated IGT. Evidence suggests that approximately 70% of individuals with untreated IFG and/or IGT end up developing type 2 diabetes.
2
Complications of diabetes mellitus begin even before diabetes occurs
Prediabetes is associated with microvascular changes. In a DPP study conducted in 2007, it was observed that 12.6% of participants with diabetes and 7.9% of participants without diabetes were diagnosed with diabetic retinopathy. Patients with prediabetes may also have neuropathy. Such microvascular complications are disabling and affect patients' quality of life and can be costly for health systems. Prediabetes is also associated with heart disease, stroke, and peripheral arterial disease.
Prediabetes is associated with microvascular changes. In a DPP study conducted in 2007, it was observed that 12.6% of participants with diabetes and 7.9% of participants without diabetes were diagnosed with diabetic retinopathy. Patients with prediabetes may also have neuropathy. Such microvascular complications are disabling and affect patients' quality of life and can be costly for health systems. Prediabetes is also associated with heart disease, stroke, and peripheral arterial disease.
3
Early detection is key
This is very important to note, as there are effective measures to prevent the progression of this disease
This is very important to note, as there are effective measures to prevent the progression of this disease
Criteria for testing for prediabetes in asymptomatic adults
Adults who are overweight or obese (BMI ≥ 25 kg/m2) and over 45 years of age who have at least one of the following risk factors:
- First-degree relatives with diabetes
- History of cardiovascular disease
- Hypertension
- History of gestational diabetes
- Elevated HDL cholesterol and/or triglyceride levels
- Lack of physical activity
- Other clinical conditions associated with insulin resistance
Glucose values for diagnosing prediabetes and diabetes conditions (according to IDF)
Impaired fasting glucose should be diagnosed if the first or both of the following are met.
Impaired glucose tolerance should be diagnosed if both of the following criteria are met.
Diabetes should be diagnosed if the one or more of the following criteria are met.
Impaired glucose tolerance should be diagnosed if both of the following criteria are met.
Diabetes should be diagnosed if the one or more of the following criteria are met.
Glucose Readings for Diagnosing Prediabetes and Diabetes (ADA)
Переклад за матеріалами IDF DIABETES ATLAS 10th edition 2021
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