Prediabetes affects nearly 90 million U.S. adults and more than 374
million people worldwide. But what exactly is prediabetes, and how
should it be treated?
Individuals with prediabetes have a high risk of progressing to type 2
diabetes. Diabetes currently affects approximately 30 million adults in
the U.S. and 463 million people worldwide, and type 2 diabetes
represents 90-95% of the diabetes burden. Individuals with prediabetes
also face increased risks of developing several complications including
heart disease. Intervention at the prediabetes stage can help prevent
progression to type 2 diabetes, and even lead to remission of
prediabetes and a return to normal blood glucose regulation (NGR).
However, a deeper understanding of the pathobiology of prediabetes is
critical to the discovery and delivery of programs for preventing of
diabetes.
Focusing on prediabetes is compelling: Understanding the numerous risk
factors that trigger the initial escape from NGR toward prediabetes
provides critical information that enables the precise and timely
targeting of preventive interventions to at-risk persons.
This book is for clinicians, researchers, public health practitioners
and policy makers. It begins with an overview of the demographic,
anthropometric, biobehavioral and biochemical factors that drive the
transition from normal blood glucose to prediabetes. Emerging knowledge
from the fields of genomics, transcriptomics, microRNAs, metabolomics
and microbiomics is incorporated into a comprehensive treatise on the
pathobiology of prediabetes.
Next, the focus shifts to evidence-based management of prediabetes and
prevention of type 2 diabetes. Prediabetes seldom remits spontaneously.
Lifestyle modification and certain medications can prevent progression
from prediabetes to type 2 diabetes and may even induce remission of
prediabetes in some people. Landmark diabetes prevention trials are
discussed through the prism of their successful translatability in
communities around the world. Emphasis is placed on practical
adaptations that would enable cost-effective community diabetes
prevention initiatives.
Interventions utilizing lifestyle modification are prioritized over
medications, but novel approaches (including cyclical medication
strategy, designer nutraceuticals and metabolic surgery) are also
discussed. Current lifestyle intervention protocols have been more
effective at preventing progression from prediabetes to type 2 diabetes
than they have been at restoring NGR. This book makes the case that
reversal of prediabetes and restoration of normal blood glucose levels
carries numerous benefits and ought to be the primary goal of
intervention in people with prediabetes.
