Pathobiology of Prediabetes: Understanding and Interrupting Progressive Dysglycemia and Associated Complications.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanisms, epidemiology, and clinical trials without systematic review or meta-analysis.
PubMed 41115173 · doi:10.2337/dbi25-0006
What was done
This narrative review synthesized the demographic, anthropometric, biobehavioral, biochemical, and molecular factors driving the transition from normal glucose regulation to prediabetes (impaired fasting glucose and impaired glucose tolerance) and type 2 diabetes. The authors also reviewed findings and limitations from landmark lifestyle and pharmacological intervention trials aimed at preventing progression.
What was found
The review reports that prediabetes affects approximately 98 million adults in the United States and over 800 million worldwide (over 541 million with impaired glucose tolerance and 319 million with impaired fasting glucose). Prediabetes carries elevated risks for vascular and neuropathic complications in addition to diabetes progression. Spontaneous sustained recovery is uncommon without intervention, though lifestyle modifications and certain pharmacotherapies can interrupt progression and restore normal glucose regulation.
Why it matters
Prediabetes represents a massive global public health burden that shares pathophysiological drivers with type 2 diabetes. Understanding early mechanistic transitions highlights the necessity of developing novel, durable interventions to reverse dysglycemia before chronic microvascular and macrovascular damage occurs.
Limits
The abstract describes a narrative overview rather than a systematic review or meta-analysis, presenting no primary empirical data or formal quantitative effect sizes for specific interventions. Specific inclusion criteria and search methods are not reported.
Cited by
- contradicts Approximately 115 million adults in the United States have pre-diabetes.