Modern-Day Management of the Dysglycemic Continuum: An Expert Viewpoint from the Arabian Gulf

Prediabetes is the first stage of a continuum that extends through the diagnosis of clinical type 2 diabetes towards long-standing diabetes with multiple comorbidities. The diagnosis of prediabetes provides an opportunity to interrupt the diabetes continuum at an early stage to ensure long-term opti...

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Bibliographic Details
Published in:Diabetes, metabolic syndrome and obesity metabolic syndrome and obesity, 2024, Vol.17, p.4791-4802
Main Authors: Alessa, Thamer, Al Awadi, Fatheya, Al Kaabi, Juma, Al Mamari, Ali, Al Ozairi, Ebaa, Alromaihi, Dalal, Elhadd, Tarik, Gunaid, Abdallah A, Hassanein, Mohamed, Jayyousi, Amin A, Kalimat, Raya, Brand, Kerstin M G
Format: Article
Language:English
Subjects:
antidiabetic therapy
Cardiovascular disease
Diabetes
diabetes complications
diabetes continuum
Fasting
Glucose
Heart attacks
Heart failure
Hyperglycemia
Hypertension
metformin
Mortality
Obesity
prediabetes
Review
Systematic review
type 2 diabetes
Weight control
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Summary:Prediabetes is the first stage of a continuum that extends through the diagnosis of clinical type 2 diabetes towards long-standing diabetes with multiple comorbidities. The diagnosis of prediabetes provides an opportunity to interrupt the diabetes continuum at an early stage to ensure long-term optimization of clinical outcomes. All people with prediabetes should receive intervention to improve their lifestyles (quality of diet and level of physical activity), as this has been proven beyond doubt to reduce substantially the risk of conversion to diabetes. Additionally, a large base of clinical evidence supports the use of metformin in preventing or delaying the transition from prediabetes to clinical type 2 diabetes, for some people with prediabetes. For many years, guidelines for the management of type 2 diabetes focused on lowering blood glucose, with metformin prescribed first for those without contraindications. More recently, guidelines have shifted towards prevention of diabetes complications as the primary goal, with increased use of GLP-1 receptor agonists (or multi-agonist incretin peptides) or SGLT-2 inhibitors for patients with existing atherosclerotic cardiovascular disease, heart failure or chronic kidney disease. Access to these medications often remains challenging. Metformin remains a suitable option for initial pharmacologic intervention to manage glycemia for many people with prediabetes or type 2 diabetes along with other therapy to maintain control of blood glucose or to address specific comorbidities as the patient progresses along the diabetes continuum.
ISSN:1178-7007
1178-7007
DOI:10.2147/DMSO.S491591