Obesity in Prediabetic Patients: Management of Metabolic Complications and Strategies for Prevention of Overt Diabetes. in Endocrine, metabolic & immune disorders drug targets / Endocr Metab Immune Disord Drug Targets. 2024 May 20. doi: 10.2174/0118715303282327240507184902.
2024
ASL Biella
ASL Novara
Tipo pubblicazione
Journal Article
Autori/Collaboratori (13)Vedi tutti...
Ponziani MC
Unit of Diabetes & Metabolic Disease, SS Trinità Hospital, Borgomanero-Arona, Italy.
Nizzoli M
Unit of Endocrinology and Metabolism G.B. Morgagni Hospital, Forlì, Italy.
Nelva A
Unit of Endocrinology and Diabetology, Ospedale degli Infermi, Ponderano, Italy.
et alii...
Abstract
Obesity and prediabetes affect a substantial part of the general population, but are largely underdiagnosed, underestimated, and undertreated. Prediabetes differs from diabetes only in the degree of hyperglycaemia consequent to the progressive decline in residual beta-cell function. Both prediabetes and diabetes occur as a consequence of insulin resistance that starts several years before the clinical onset of overt diabetes. Macrovascular complications in patients with diabetes are mainly caused by insulin resistance. This is why in prediabetes, the overall cardiovascular risk is, by all means, similar to that in patients with diabetes. It is important, therefore, to identify prediabetes and treat patients not only to prevent or delay the onset of diabetes, but to reduce the cardiovascular risk associated with prediabetes. This review provides an overview of the pathophysiology of prediabetes in patients with obesity and the progression toward overt diabetes. We have reviewed nutritional and pharmacological approaches to the management of obesity and reduced glucose tolerance, and the treatment of the major comorbidities in these patients, including hypertension, dyslipidaemia, and Metabolic dysfunction-associated Steatotic Liver Disease (MASLD), has also been reviewed. In patients with obesity and prediabetes, the nutritional approach is similar to that adopted for patients with obesity and diabetes; treatments of dyslipidaemia and hypertension also have the same targets compared to patients with diabetes. MASLD is a critical issue in these patients; in the prediabetic state, MASLD rarely progresses into fibrosis. This highlights the importance of the early recognition of this pathological condition before patients become diabetic when the risk of fibrosis is much higher. It is necessary to raise awareness of the clinical relevance of this pathological condition in order to prompt early intervention before complications occur. The single most important therapeutic goal is weight loss, which must be early and persistent.
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PMID : 38778593
DOI : 10.2174/0118715303282327240507184902
Keywords
pharmacological therapy; obesity comorbidities.; nutrition; lifestyle; fatty liver disease; diabetes prevention; Obesity; prediabetes;