Early identification of macro and microvascular risk in people with prediabetes

Abstract

Prediabetes is a widely used term in clinical practice, with a profound psychosocial impact, which neutralizes its true alarming potential for patients and healthcare personnel.

This is because it refers to only one possible component: the development or absence of diabetes mellitus (DM), when in reality it constitutes a state of hepato-cardio-renal metabolic toxicity and inflammation that corresponds to a marked increase in cardiovascular risk. Its pathophysiological basis has been proven for many years, explainable by the accumulation, dissemination, and dysfunction of visceral adipose tissue and its proinflammatory secretory modifications, which close their (non-virtuous) cycle in the decline in peripheral glucose consumption: dysglycemia.

It constitutes a true (metabolic) syndrome in itself and an opportunity for early screening for risk factors and their early management to reduce cardiovascular morbidity and mortality. Only basic elements are needed to categorize risk, semiology, minimum laboratory requirements, and cardiological assessment (ECG-2D ECHO), so it is strategic to internalize this concept for all primary care physicians.