Vol 2, No 4 (2013)
Review article
Published online: 2013-09-03

open access

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Prediabetes — time for non-pharmacologic and pharmacologic intervention

Leszek Czupryniak
Diabetologia Kliniczna 2013;2(4):144-149.

Abstract

2.5 million individuals in Poland suffer from diabetes, including every fourth person aged > 60. The challenge is to diagnose type 2 diabetes early as at the beginning it causes very few significant clinical symptoms or signs. Type 2 diabetes is typically preceded by prediabetes, the term which encompasses impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). IFG subjects have 5-fold, and IGT 6-fold greater yearly risk of developing diabetes. Moreover, hyperglycemia is exerting its damaging effect on vasculature already at the stage of prediabetes as cardiovascular risk is raised by 70% in IGT and by 20% in IFG subjects. According tothe recommendations of Diabetes Poland subjects with prediabetes should be offered non-pharmacological treatment aiming at body weight loss through caloric restriction and increased physical activity as well as — more recently — pharmacotherapy with the use of metformin. Upon a set of clinical cases, the paper discusses therapeutic options for individuals with prediabetes.