Prediabetes is associated with elevated risk of clinical outcomes even without progression to diabetes – published online 12/11/2024
Mary R. Rooney, Amelia S. Wallace, Justin B. Echouffo Tcheugui, Michael Fang, Jiaqi Hu, Pamela L. Lutsey, Morgan E. Grams, Josef Coresh, Elizabeth Selvin
Prediabetes (classified here as HbA1c 39–47 mmol/mol [5.7–6.4%] or fasting glucose 5.6–6.9 mmol/l) is associated with elevated risks of microvascular and macrovascular complications among middle-aged adults. However, it is unknown to what extent the associations of prediabetes with long-term risks of clinical outcomes remain after accounting for their intervening progression to type 2 diabetes. In this issue, Rooney et al (https://doi.org/10.1007/s00125-024-06315-0) characterised long-term risks of macrovascular and microvascular outcomes in people with prediabetes at baseline before and after accounting for progression to incident diabetes. The authors found that progression to diabetes explained less than one-quarter of the risks of clinical outcomes associated with prediabetes. They conclude that these results highlight the importance of routine screening for prediabetes, and of primary prevention interventions to reduce the incidence of cardiovascular and kidney disease among people with prediabetes.