Prediabetes and Cardiovascular Disease: Pathophysiology and Interventions for Prevention and Risk Reduction

• Published in: Endocrinology and metabolism clinics of North America Vol. 47; no. 1; p. 33
• Main Authors: Brannick, Ben, Dagogo-Jack, Sam
• Format: Journal Article
• Language: English
• Published: United States 01.03.2018
• Subjects: Cardiovascular Diseases - etiology; Cardiovascular Diseases - metabolism; Cardiovascular Diseases - prevention & control; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - prevention & control; Disease Progression; Humans; Prediabetic State - complications; Prediabetic State - metabolism; Prediabetic State - therapy; Risk Reduction Behavior; Cardiovascular disease; Impaired fasting glucose; Prediabetes complications; Impaired glucose tolerance; Macrovascular
• ISSN: 1558-4410
• DOI: 10.1016/j.ecl.2017.10.001

Prediabetes is a state characterized by impaired fasting glucose or impaired glucose tolerance. This review discusses the pathophysiology and macrovascular complications of prediabetes. The pathophysiologic defects underlying prediabetes include insulin resistance, alpha- and beta-cell dysfunction, increased lipolysis, inflammation, and suboptimal incretin effect. Recent studies have revealed that the long-term complications of diabetes manifest in some people with prediabetes; these complications include microvascular and macrovascular disorders. Finally, we present an overview of randomized control trials aimed at preventing progression from prediabetes to type 2 diabetes and discuss their implications for macrovascular risk reduction.