The prediabetes conundrum: striking the balance between risk and resources

Area of Science:

• Endocrinology
• Public Health
• Healthcare Management

Background:

• Prediabetes is a significant risk factor for type 2 diabetes, characterized by high prevalence and association with diabetic complications and mortality.
• The current definition of prediabetes is debated, yet its growing burden poses a future strain on healthcare systems.
• Effective strategies are needed to mitigate the health and economic impact of prediabetes.

Purpose of the Study:

• To propose a pragmatic approach for managing prediabetes by stratifying individuals based on risk.
• To address the challenge of resource allocation for prediabetes prevention and management.
• To advocate for differentiated treatment strategies for prediabetes patients with and without existing complications.

Main Methods:

• Literature review and expert consensus to address the controversy surrounding prediabetes definition and management.
• Development of a risk stratification model to identify high-risk individuals for targeted preventive interventions.
• Proposal for a treatment paradigm shift for prediabetes patients with concurrent diabetes-related complications.

Main Results:

• A proposed compromise suggests focusing individual-level preventive interventions on high-risk prediabetes populations.
• Identification and management of prediabetes patients with existing diabetes-related complications should mirror that of established type 2 diabetes.
• This approach aims to optimize healthcare resource utilization and reduce the overall burden of prediabetes.

Conclusions:

• Stratifying prediabetes based on risk allows for targeted preventive strategies, optimizing resource allocation.
• Individuals with prediabetes and existing complications warrant treatment akin to established type 2 diabetes.
• This dual approach addresses both prevention and complication management in the prediabetes population, mitigating future healthcare costs.