An Expert Group Consensus Statement on "Approach and Management of Prediabetes in India"

Area of Science:

• Endocrinology
• Public Health
• Epidemiology

Background:

• Prediabetes is a significant risk factor for diabetes and its complications, particularly macrovascular issues.
• Asian Indians exhibit a high prevalence and rapid progression of prediabetes to type 2 diabetes.
• The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study highlights the substantial burden of prediabetes across India.

Purpose of the Study:

• To emphasize prediabetes as a critical window for intervention rather than an inevitable precursor to diabetes.
• To advocate for making early screening, detection, and management of prediabetes a national health priority in India.
• To provide a consensus statement on screening and management strategies for prediabetes in Asian Indians.

Main Methods:

• Analysis of data from the large, community-based epidemiological ICMR-INDIAB study.
• Review of international approaches to lifestyle and pharmacological interventions for prediabetes.
• Development of a consensus statement based on epidemiological findings and existing management guidelines.

Main Results:

• The ICMR-INDIAB study reported an overall prediabetes prevalence of 10.3% across 15 Indian states.
• The high prevalence indicates a continued diabetes epidemic with many individuals progressing to diabetes.
• Prediabetes management presents a critical opportunity for preventing diabetes onset and complications.

Conclusions:

• Prediabetes requires urgent attention as a public health issue in Asian Indians due to high prevalence and rapid conversion to diabetes.
• Screening, early detection, and timely intervention, including lifestyle modifications and pharmacological treatment (e.g., metformin), are essential.
• Implementing comprehensive prediabetes management strategies should be a national priority to mitigate the growing diabetes epidemic and its associated health burdens.