Prediabetes

Abstract

Prediabetes (impaired glucose homeostasis) is clinically silent period preceding overt diabetes. Increased fasting glycaemia and/ or higher glycaemia after glucose load are observed but glycaemia values do not reach the threshold diagnostic for diabetes. Currently prediabetes is not considered to be a specific clinical entity (disease) despite the evidence documenting that “toxic car‑ dio‑metabolic” processes during prediabetes are harmful and may for instance initiate the development of chronic microvascular complications. In prediabetes pathogenesis the development of insulin resistance is crucial. First step towards the development of insulin resistance may occur already in utero. Maternal metabolic status can initiate insulin resistance in foetal brain with import‑ ant consequences later during postnatal life. To prevent the progression of impaired glucose homeostasis into diabetes life style modifications (healthy diet, physical activity) are considered now to be superior over drugs targeting insulin resistance despite known problems with adherence. In the article current concept of prediabetes pathogenesis, its importance, new biomarkers and preventive (therapeutic) possibilities are further discussed.