Even the pre-stage to type 2 diabetes increases the risk of serious complications. This was shown in a review by the DZD partner German Diabetes Center.
Prediabetes is a preliminary stage of type 2 diabetes in which glucose metabolism is already disturbed, but glucose or HbA1c levels are not yet high enough to be diagnosed as diabetes. Studies in recent years suggest that even this preliminary stage may be associated with chronic complications and sequelae. In an umbrella review, researchers have compiled a systematic overview of the studies to date and analyzed and evaluated their significance.
To this end, the researchers evaluated 95 meta-analyses. These meta-analyses had included prospective studies of prediabetes and the incidence of diabetes-related complications, comorbidities, or risk of death if they met the following eligibility criteria: Prediabetes had to be defined by blood glucose or HbA1c levels that were above normal but not high enough to be diagnosed as diabetes. Participants had to be adults (≥18 years of age).
The results show that prediabetes is associated with an increased risk of complications such as cardiovascular disease, CHD, stroke, chronic kidney disease, dementia, as well as cancer and higher mortality rates in general. Prediabetes is thus more dangerous than assumed and requires increased attention not only by the scientific community but also in clinical practice. The results are rated as moderately robust, meaning that the findings likely reflect the true association. The certainty of evidence was evaluated by applying the GRADE tool.
The researchers note that further high-quality studies, particularly on HbA1c-defined prediabetes and other relevant health outcomes (e. g. neuropathy) are required to support the evidence.
Schlesinger S, Neuenschwander M, Barbaresko J, Lang A, Maalmi H, Rathmann W, Roden M, Herder C. Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies. Diabetologia. 2022 Feb;65(2):275-285. doi: 10.1007/s00125-021-05592-3.