Pre-Diabetes, Metabolic Syndrome, and Cardiovascular Risk

Grundy, Scott M.

doi:10.1016/j.jacc.2011.08.080

Cited by 627Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementCardiovascular Function and Risk Factors

Pre-Diabetes, Metabolic Syndrome, and Cardiovascular Risk

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Grundy, Scott M.·2012·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2011.08.080

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Abstract

Pre-diabetes represents an elevation of plasma glucose above the normal range but below that of clinical diabetes. Pre-diabetes can be identified as either impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). The latter is detected by oral glucose tolerance testing. Both IFG and IGT are risk factors for type 2 diabetes, and risk is even greater when IFG and IGT occur together. Pre-diabetes commonly associates with the metabolic syndrome. Both in turn are closely associated with obesity. The mechanisms whereby obesity predisposes to pre-diabetes and metabolic syndrome are incompletely understood but likely have a common metabolic soil. Insulin resistance is a common factor; systemic inflammation engendered by obesity may be another. Pre-diabetes has only a minor impact on microvascular disease; glucose-lowering drugs can delay conversion to diabetes, but whether in the long run the drug approach will delay development of microvascular disease is in dispute. To date, the drug approach to prevention of microvascular disease starting with pre-diabetes has not been evaluated. Pre-diabetes carries some predictive power for macrovascular disease, but most of this association appears to be mediated through the metabolic syndrome. The preferred clinical approach to cardiovascular prevention is to treat all the metabolic risk factors. For both pre-diabetes and metabolic syndrome, the desirable approach is lifestyle intervention, especially weight reduction and physical activity. When drug therapy is contemplated and when the metabolic syndrome is present, the primary consideration is prevention of cardiovascular disease. The major targets are elevations of cholesterol and blood pressure.

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The key determinants of the postprandial blood glucose response are the amount, rate and extent of carbohydrate digestion, insulin secretory response, and gastric emptying.
“The key determinants of the postprandial blood glucose response are the amount, rate and extent of carbohydrate digestion [4], insulin secretory response [5] and gastric emptying [6,7].”
From Effect of Cold Storage and Reheating of Parboiled Rice on Postprandial Glycaemic Response, Satiety, Palatability and Chewed Particle Size Distribution (2017) · cites this paper as [5]

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Inflammation and diabetes-accelerated atherosclerosis: myeloid cell mediators
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Regional Heterogeneity of Perivascular Adipose Tissue: Morphology, Origin, and Secretome
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Metabolic syndrome influences cardiac gene expression pattern at the transcript level in male ZDF rats
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Is type 2 diabetes mellitus a coronary heart disease equivalent or not? Do not just enjoy the debate and forget the patient!
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Chronic leucine supplementation increases body weight and insulin sensitivity in rats on high‐fat diet likely by promoting insulin signaling in insulin‐target tissues
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Effects of an energy-restricted diet rich in plant-derived α-linolenic acid on systemic inflammation and endothelial function in overweight-to-obese patients with metabolic syndrome traits
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Metabolic Signatures of Cultured Human Adipocytes from Metabolically Healthy versus Unhealthy Obese Individuals
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Gut microbiota-based translational biomarkers to prevent metabolic syndrome via nutritional modulation
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HDLs, Diabetes, and Metabolic Syndrome
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Cardiovascular Risk Factor Profiles for Peripheral Artery Disease and Carotid Atherosclerosis among Chinese Older People: A Population-Based Study
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Glycemic Variability in Nondiabetic Morbidly Obese Persons
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Cardiovascular Risk Stratification and Management in Pre-Diabetes
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Studies of a microchip flow-chamber system to characterize whole blood thrombogenicity in healthy individuals
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Prevalence and Predictors of Pre-Diabetes and Diabetes among Adults 18 Years or Older in Florida: A Multinomial Logistic Modeling Approach
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A polymorphism of HMGA1 is associated with increased risk of metabolic syndrome and related components
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Role of red grape polyphenols as antidiabetic agents
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Beneficial effects of probiotic and synbiotic supplementation on some cardiovascular risk factors among individuals with prediabetes and type 2 diabetes mellitus: A grade-assessed systematic review, meta-analysis, and meta-regression of randomized clinical trials
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Medical Nutrition Therapy and Weight Loss Questions for the Evidence Analysis Library Prevention of Type 2 Diabetes Project: Systematic Reviews
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Authors: Grundy, S. M.
Affiliations: The University of Texas Southwestern Medical Center (US)
Corresponding author: Grundy, Scott M.
ORCID: Grundy, Scott M.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2012-02
Volume: 59
Issue: 7
Pages: 635-643
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2011.08.080
OpenAlex: W2078784990
Cited by: 627
References: 83
Citations by year: 2026: 20 · 2025: 18 · 2024: 28 · 2023: 31 · 2022: 44 · 2021: 59 · 2020: 45 · 2019: 47 · 2018: 46 · 2017: 53 · 2016: 61 · 2015: 52 · 2014: 51 · 2013: 51 · 2012: 19
FWCI: 7.69
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 568 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: prediabetes, metabolic syndrome, cardiovascular risk, impaired fasting glucose, impaired glucose tolerance, type 2 diabetes, obesity, insulin resistance, systemic inflammation, microangiopathy, macroangiopathy, antidiabetic drugs, lifestyle intervention, weight loss, physical activity, cholesterol, blood pressure
MeSH terms: Animals, Blood Glucose, Cardiovascular Diseases, Humans, Prediabetic State, Risk Factors, Metabolic Syndrome, Risk Reduction Behavior

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