Lizarzaburu-Robles Juan Carlos, Herman William H, Garro-Mendiola Alonso, Galdón Sanz-Pastor Alba, Lorenzo Oscar
Endocrinology Unit, Hospital Central de la Fuerza Aérea del Perú, 15046 Lima, Peru.
Doctorate Program, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
Biomedicines. 2024 Feb 4;12(2):363. doi: 10.3390/biomedicines12020363.
The progression from prediabetes to type-2 diabetes depends on multiple pathophysiological, clinical, and epidemiological factors that generally overlap. Both insulin resistance and decreased insulin secretion are considered to be the main causes. The diagnosis and approach to the prediabetic patient are heterogeneous. There is no agreement on the diagnostic criteria to identify prediabetic subjects or the approach to those with insufficient responses to treatment, with respect to regression to normal glycemic values or the prevention of complications. The stratification of prediabetic patients, considering the indicators of impaired fasting glucose, impaired glucose tolerance, or HbA1c, can help to identify the sub-phenotypes of subjects at risk for T2DM. However, considering other associated risk factors, such as impaired lipid profiles, or risk scores, such as the Finnish Diabetes Risk Score, may improve classification. Nevertheless, we still do not have enough information regarding cardiovascular risk reduction. The sub-phenotyping of subjects with prediabetes may provide an opportunity to improve the screening and management of cardiometabolic risk in subjects with prediabetes.
从糖尿病前期进展为2型糖尿病取决于多种通常相互重叠的病理生理、临床和流行病学因素。胰岛素抵抗和胰岛素分泌减少均被视为主要原因。糖尿病前期患者的诊断和处理方法并不统一。在识别糖尿病前期受试者的诊断标准或对治疗反应不足者（就血糖值恢复正常或预防并发症而言）的处理方法上，尚无共识。考虑空腹血糖受损、糖耐量受损或糖化血红蛋白等指标对糖尿病前期患者进行分层，有助于识别2型糖尿病高危受试者的亚表型。然而，考虑其他相关危险因素，如血脂异常，或风险评分，如芬兰糖尿病风险评分，可能会改善分类。尽管如此，我们仍然没有足够的关于降低心血管风险的信息。对糖尿病前期受试者进行亚表型分析可能为改善糖尿病前期受试者心血管代谢风险的筛查和管理提供机会。
