Diagnosis and treatment of prediabetes as prevention of type 2 diabetes: A review

Abstract

Prediabetes is defined as a disorder in which the criteria for diabetes mellitus are not met, but normal blood glucose values are exceeded; this intermediate hyperglycemia is associated with a high risk of developing diabetes and cardiovascular disease. The number of patients with diabetes mellitus continues to grow steadily, and therefore the role of timely interventions at the stage of prediabetes is obvious. A modern approach to preventing the progression of prediabetes includes correcting risk factors for cardiovascular diseases, arterial hypertension, dyslipidemia, weight loss and/or prevention of weight gain, and improving the quality of life. The first-line therapy for prediabetes is lifestyle modification, which includes changes in diet, physical activity, weight management, bad habits, and sleep hygiene. Thus, a non-pharmacological approach to the treatment of patients, aimed at reducing excess weight, plays a major role. In conditions of insufficient effectiveness of measures to change lifestyle, it is advisable to prescribe drug therapy. Metformin is the first-line drug for preventing the progression of carbohydrate metabolism disorders. In addition to lifestyle modification, orlistat, drugs from the group of GLP-1 analogues, thiazolidinediones, and acarbose have also demonstrated their effectiveness. Bariatric surgery is associated with improved glycemic control in prediabetic patients.