Impaired glucose tolerance: is there a case for pharmacologic intervention?

Area of Science:

• Endocrinology
• Metabolic Disorders
• Cardiovascular Disease Epidemiology

Background:

• Impaired glucose tolerance (IGT) is characterized by elevated postprandial glucose levels, identified via oral glucose tolerance testing.
• IGT is a significant risk factor for developing type 2 diabetes mellitus and cardiovascular disease (CVD).
• IGT is a component of the metabolic syndrome, closely linked with other CVD risk factors like hypertension and dyslipidemia.

Purpose of the Study:

• To highlight the role of IGT as an early indicator in the progression to type 2 diabetes.
• To discuss the association between IGT and increased risk of vascular complications.
• To review current strategies for preventing or delaying type 2 diabetes in individuals with IGT.

Main Methods:

• Review of epidemiologic and prospective trial data, including the DECODE study.
• Analysis of the relationship between IGT, metabolic syndrome components, and cardiovascular risk.
• Evaluation of evidence for interventions aimed at preventing type 2 diabetes in IGT populations.

Main Results:

• IGT is the earliest identifiable metabolic abnormality preceding type 2 diabetes.
• IGT is associated with a high risk of developing type 2 diabetes and subsequent vascular morbidity/mortality.
• The impact of treating IGT on macrovascular complications remains under investigation.

Conclusions:

• The primary goal of identifying and treating IGT is to prevent or delay the onset of type 2 diabetes mellitus.
• Lifestyle interventions (diet, exercise) and pharmacotherapy (metformin, acarbose) are effective in reducing type 2 diabetes incidence.
• Prevention or delay of type 2 diabetes is achievable in individuals with IGT through lifestyle modification or medication.