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Prediabetes and What It Means: The Epidemiological Evidence
Annual Review of Public Health ( IF 21.4 ) Pub Date : 2021-04-02 , DOI: 10.1146/annurev-publhealth-090419-102644
Justin B Echouffo-Tcheugui 1, 2 , Elizabeth Selvin 2, 3
Affiliation  

Prediabetes is an intermediate stage between normal glycemia and diabetes and is highly prevalent, especially in older age groups and obese individuals. Five different definitions of prediabetes are used in current practice, which are based on different cut points of HbA1C, fasting glucose, and 2-h glucose. A major challenge for the field is a lack of guidance on when one definition might be preferred over another. Risks of major complications in persons with prediabetes, including diabetes, cardiovascular disease, kidney disease, and death, also vary depending on the prediabetes definition used. Randomized clinical trials have demonstrated that lifestyle and pharmacologic interventions can be cost-effective, prevent diabetes, and improve cardiovascular risk factors in adults with prediabetes. However, the practical implementation of lifestyle modification or the use of metformin for treating prediabetes is inadequate and complicated by a lack of agreement on how to define the condition. Establishing consensus definitions for prediabetes should be a priority and will help inform expansion of insurance coverage for lifestyle modification and improve current screening and diagnostic practices.

中文翻译:


糖尿病前期及其意义:流行病学证据

糖尿病前期是正常血糖和糖尿病之间的中间阶段,非常普遍,尤其是在老年组和肥胖个体中。当前实践中使用了五种不同的前驱糖尿病定义,它们基于 HbA 1C 的不同切点、空腹血糖和 2 小时血糖。该领域的一个主要挑战是缺乏关于何时一个定义可能比另一个更受欢迎的指导。糖尿病前期患者的主要并发症风险,包括糖尿病、心血管疾病、肾脏疾病和死亡,也因所使用的糖尿病前期定义而异。随机临床试验表明,生活方式和药物干预具有成本效益,可以预防糖尿病并改善糖尿病前期成人的心血管危险因素。然而,生活方式改变或使用二甲双胍治疗糖尿病前期的实际实施并不充分,而且由于对如何定义病情缺乏共识而变得复杂。

更新日期:2021-04-04
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