Prediabetes is an intermediate state of
hyperglycemia with glycemic parameters above normal but below the diabetes threshold. While, the diagnostic criteria of
prediabetes are not uniform across various international professional organizations, it remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between
prediabetes and complications of diabetes such early nephropathy,
small fiber neuropathy, early retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with
prediabetes. While there is increasing evidence to prove the efficacy of
pharmacotherapy in prevention of diabetes in adults with
prediabetes,
pharmaceutical treatment options other than
metformin are associated with adverse effects that limit their use for
prediabetes. There are no reports of systematic evaluation of health outcomes related to
prediabetes in children. The effects of
pharmacotherapy of
prediabetes on growth and pubertal development in children remains unknown. Secondary intervention with
pharmacotherapy with
metformin is advocated for high-risk individuals but criteria for such consideration benefit of early intervention, long term cost effectiveness of such interventions and the end point of
therapy remain unclear.
Pharmacotherapy must be used with caution in children with
prediabetes.
Prediabetes is a condition defined as having
blood glucose levels above normal but below the defined threshold of diabetes. It is considered to be an at risk state, with high chances of developing diabetes. While,
prediabetes is commonly an
asymptomatic condition, there is always presence of
prediabetes before the onset of diabetes. The elevation of
blood sugar is a continuum and hence
prediabetes can not be considered an entirely benign condition. This aim of this review is to describe the challenges associated with diagnosis of
prediabetes, the possible adverse medical outcomes associated with
prediabetes and the treatment options and rationale for their use in context of
prediabetes.