Kanat Mustafa, DeFronzo Ralph A, Abdul-Ghani Muhammad A
Mustafa Kanat, Division of Diabetes, Department of Internal Medicine, Istanbul Medipol University, 34214 Istanbul, Turkey.
World J Diabetes. 2015 Sep 25;6(12):1207-22. doi: 10.4239/wjd.v6.i12.1207.
Progression of normal glucose tolerance (NGT) to overt diabetes is mediated by a transition state called impaired glucose tolerance (IGT). Beta cell dysfunction and insulin resistance are the main defects in type 2 diabetes mellitus (type 2 DM) and even normoglycemic IGT patients manifest these defects. Beta cell dysfunction and insulin resistance also contribute to the progression of IGT to type 2 DM. Improving insulin sensitivity and/or preserving functions of beta-cells can be a rational way to normalize the GT and to control transition of IGT to type 2 DM. Loosing weight, for example, improves whole body insulin sensitivity and preserves beta-cell function and its inhibitory effect on progression of IGT to type 2 DM had been proven. But interventions aiming weight loss usually not applicable in real life. Pharmacotherapy is another option to gain better insulin sensitivity and to maintain beta-cell function. In this review, two potential treatment options (lifestyle modification and pharmacologic agents) that limits the IGT-type 2 DM conversion in prediabetic subjects are discussed.
正常糖耐量（NGT）向显性糖尿病的进展是由一种称为糖耐量受损（IGT）的过渡状态介导的。β细胞功能障碍和胰岛素抵抗是2型糖尿病（2型DM）的主要缺陷，甚至血糖正常的IGT患者也表现出这些缺陷。β细胞功能障碍和胰岛素抵抗也促使IGT进展为2型DM。改善胰岛素敏感性和/或保留β细胞功能可能是使糖耐量正常化以及控制IGT向2型DM转变的合理方法。例如，体重减轻可改善全身胰岛素敏感性并保留β细胞功能，并且其对IGT进展为2型DM的抑制作用已得到证实。但是旨在减肥的干预措施在现实生活中通常并不适用。药物治疗是提高胰岛素敏感性和维持β细胞功能的另一种选择。在本综述中，讨论了两种可限制糖尿病前期受试者从IGT转变为2型DM的潜在治疗选择（生活方式改变和药物制剂）。
