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Prediabetes and What It Means: The Epidemiological Evidence

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Echouffo-Tcheugui, Justin B., Selvin, Elizabeth·2021·Annual Review of Public Health

DOI 10.1146/annurev-publhealth-090419-102644PMC PMC8026645

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Abstract

Prediabetes is an intermediate stage between normal glycemia and diabetes and is highly prevalent, especially in older age groups and obese individuals. Five different definitions of prediabetes are used in current practice, which are based on different cut points of HbA 1C , fasting glucose, and 2-h glucose. A major challenge for the field is a lack of guidance on when one definition might be preferred over another. Risks of major complications in persons with prediabetes, including diabetes, cardiovascular disease, kidney disease, and death, also vary depending on the prediabetes definition used. Randomized clinical trials have demonstrated that lifestyle and pharmacologic interventions can be cost-effective, prevent diabetes, and improve cardiovascular risk factors in adults with prediabetes. However, the practical implementation of lifestyle modification or the use of metformin for treating prediabetes is inadequate and complicated by a lack of agreement on how to define the condition. Establishing consensus definitions for prediabetes should be a priority and will help inform expansion of insurance coverage for lifestyle modification and improve current screening and diagnostic practices.

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Authors: Echouffo-Tcheugui, J. B., & Selvin, E.
Affiliations: Johns Hopkins University (US)
ORCID: Echouffo-Tcheugui, Justin B.
Selvin, Elizabeth
Venue: Annual Review of Public Health
Publisher: Annual Reviews
Published: 2021-04-01
Volume: 42
Issue: 1
Pages: 59-77
ISSN: 0163-7525 (ISSN-L)
1545-2093
DOI: 10.1146/annurev-publhealth-090419-102644
PMC: PMC8026645
OpenAlex: W3116592557
Cited by: 406
References: 31
Citations by year: 2026: 80 · 2025: 114 · 2024: 103 · 2023: 62 · 2022: 43 · 2021: 4
FWCI: 4.18
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: Annual Review of Public Health (publishedVersion, cc-by)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (K24HL152440, K23HL153774)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: prediabetes, fasting blood glucose, 2-hour oral glucose tolerance test, diabetes prevention, cardiovascular risk, kidney disease, metformin, lifestyle modification, cost-effectiveness, prediabetes screening, insurance coverage, consensus definition
MeSH terms: Humans, Prediabetic State, Randomized Controlled Trials as Topic

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Prediabetes and What It Means: The Epidemiological Evidence

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