Prediabetes, which is usually defined as blood glucose concentrations higher than normal but lower than the threshold for diabetes, is a high-risk state for diabetes and cardiovascular disease. It affects three groups of individuals: those with impaired fasting glucose (IFG), those with impaired glucose tolerance (IGT) and those with glycated hemoglobin (HbA1c) between 39-46 mmol/mol. Clinical trials have shown the importance of IFG, IGT and HbA1c-prediabetes in predicting the risk of type 2 diabetes. Moreover, with regard to cardiovascular disease, prediabetes is associated with more advanced vascular damage than normoglycemia, independently of confounding factors. It is therefore clearly mandatory to diagnose prediabetes promptly in order to prevent or delay the full development of the disease and its complications. However, prediabetes diagnoses by IFG, IGT or HbA1c are not always concordant and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review looks at recent studies and current controversies in the field. In view of the expected increased use of HbA1c as a screening tool to identify individuals with altered glycemic homeostasis, we focused on the utility of HbA1c as a diagnostic tool for prediabetes and as a marker for identifying patients who have an increased risk of cardiovascular disease. We also review current evidence about non-traditional glycemic biomarkers and their use as alternative or complementary to traditional ones.

Prediabete: Criteri diagnostici e rischio cardiovascolare

Di Pino, A.;Urbano, F.;Piro, S.;Purrello, Francesco;Rabuazzo, A. M.
2016

Abstract

Prediabetes, which is usually defined as blood glucose concentrations higher than normal but lower than the threshold for diabetes, is a high-risk state for diabetes and cardiovascular disease. It affects three groups of individuals: those with impaired fasting glucose (IFG), those with impaired glucose tolerance (IGT) and those with glycated hemoglobin (HbA1c) between 39-46 mmol/mol. Clinical trials have shown the importance of IFG, IGT and HbA1c-prediabetes in predicting the risk of type 2 diabetes. Moreover, with regard to cardiovascular disease, prediabetes is associated with more advanced vascular damage than normoglycemia, independently of confounding factors. It is therefore clearly mandatory to diagnose prediabetes promptly in order to prevent or delay the full development of the disease and its complications. However, prediabetes diagnoses by IFG, IGT or HbA1c are not always concordant and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review looks at recent studies and current controversies in the field. In view of the expected increased use of HbA1c as a screening tool to identify individuals with altered glycemic homeostasis, we focused on the utility of HbA1c as a diagnostic tool for prediabetes and as a marker for identifying patients who have an increased risk of cardiovascular disease. We also review current evidence about non-traditional glycemic biomarkers and their use as alternative or complementary to traditional ones.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/364119
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