Prediabetic conditions

1. Big picture

Prediabetic conditions are intermediate glucose disorders between normal glucose metabolism and diabetes mellitus. The key exam idea is:

Prediabetes = high-risk metabolic state, not yet diabetes, but already dangerous.

It matters because patients are usually asymptomatic, but they already have:

• increased risk of type 2 diabetes mellitus
• increased risk of atherosclerotic cardiovascular disease
• frequent association with central obesity, hypertension, dyslipidemia, fatty liver, polycystic ovary syndrome, and metabolic syndrome

The examiner wants you to know three things very clearly:

1. Definitions and diagnostic cut-offs
2. Who should be screened
3. How to prevent progression to diabetes

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