Pathophysiology of prediabetes

Prediabetes encompasses conventional diagnostic categories of impaired fasting glucose and impaired glucose tolerance but is a band of glucose concentrations and a temporal phase over a continuum extending from conventional normal glucose tolerance to overt type 2 diabetes. Insulin resistance and defective glucose sensing at the β-cell are the central pathophysiologic determinants that together cause hyperglycemia. Regardless of the cellular origin of insulin resistance, excessive tissue fat utilization is a consistent metabolic mechanism. Although genetic influences affect β-cell function, becoming overweight is the main acquired challenge to insulin action. The phenotype of prediabetes includes dyslipidemia and higher arterial blood pressure.