Global epidemiology of prediabetes - present and future perspectives

Abstract

Prediabetes is defined as an intermediate state of hyperglycaemia with glucose levels above the normal state but below the diagnostic levels of diabetes. It is increasingly recognised as an important metabolic state, as individuals with prediabetes are at high risk of developing overt diabetes and its associated complications. A better understanding of prediabetes could help with earlier identification, thereby allowing earlier intervention, potentially lowering the number of individuals who go on to develop diabetes. The definitions and screening criteria for prediabetes differ between guidelines published by different organisations, resulting in estimations of prevalence that can vary widely from one another. Despite these differences, these estimates suggest that the number of individuals affected by prediabetes is increasing rapidly in all areas of the world. This short review compares and contrasts the diagnostic criteria for screening of prediabetes, the impact of various glycaemic measures on prevalence estimates, and discusses current and future trends in the global prevalence estimates of prediabetes.

Keywords: Diabetes; Global burden; Prediabetes; Prevalence; Screening tools.

Fig. 1

Global prevalence estimates of IGT by IDF region [9]. Data source: IDF Diabetes Atlas – 8th Edition. Percentages represent unadjusted regional prevalence estimates. Numbers in parentheses represent the estimated number of individuals affected by IGT in each region. Prevalence estimates calculated by the IDF using a generalised linear regression model. A variety of country-level data sources were included, mostly from peer-reviewed journals and national health surveys. The studies selected were required to meet rigorous inclusion criteria based on input from international experts. Prevalence in countries without original data available was extrapolated based on data collected from similar countries, based on ethnicity, income level and geography. IDF, International Diabetes Federation; IGT, impaired glucose tolerance; m, million