Prediabetes
Burden
1
Epidemiology:
Health Performance Gaps
• Prevalence
• Risk factors
– Metabolic syndrome
– Obesity
• Clinical risks of prediabetes
– Progression to diabetes
• Complications (eg, retinopathy)
2
Progression to Type 2 Diabetes
Impaired
Glucose
Tolerance
Impaired
Fasting
Glucose
Or both
Prediabetes
3
Diabetes
Prevalence of Diabetes and
Prediabetes in the United States
120
Increased incidence of prediabetes from 2007 to 2010
7.0
Persons (millions)
100
18.8
80
60
5.7
17.9
40
57
20
Undiagnosed
Diabetes
Diagnosed
Diabetes
Prediabetes
Diabetes
8.3% of US population
Prediabetes
79
35% of US population
0
2007
2010
4
CDC and Prevention. National diabetes fact sheet, 2007. http://www.cdc.gov/Diabetes/pubs/pdf/ndfs_2007.pdf.
CDC and Prevention. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.
Prevalence of IFG and IGT in US Adults
Without T2DM: NHANES Data
Incidence of prediabetes, IFG, and IGT in a
representative sample of the US population
40%
35%
34.6%
30%
25%
19.4%
20%
15%
9.8%
10%
5.4%
5%
0%
Prediabetes
5
IFG only
IGT only
IFG and IGT
IFG, impaired fasting glucose; IGT, impaired glucose tolerance; NHANES, National Health and Nutrition
Examination Survey ; T2DM , type 2 diabetes mellitus.
Karve A, Hayward RA. Diabetes Care. 2010;33:2355-2359.
How Much Does the Metabolic
Syndrome Raise the Risk of T2DM?
Odds Ratio
(Confidence Interval)
25.0
T2DM risk, stratified by IFG and
metabolic syndrome
21.0
(13.1-33.8)
20.0
10.0
7.07
5.03
(3.32-15.1)
(3.39-7.48)
5.0
1.0
(ref)
1.0
No MetSyn
No IFG
MetSyn
without
IFG
IFG
without
MetSyn
MetSyn
+
IFG
6
IFG, impaired fasting glucose; MetSyn, metabolic syndrome; T2DM, type 2 diabetes mellitus.
Lorenzo C, et al. Diabetes Care. 2007;30:8-13.