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Kantartzis, K. ; Fritsche, A. ; Birkenfeld, A.L.

Prädiabetes als therapeutische Herausforderung in der Inneren Medizin.

Prediabetes as a therapeutic challenge in internal medicine.

Innere Med. 64, 636-641 (2023)
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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
The term prediabetes describes a fasting blood glucose level that is elevated but not yet in the diabetic range, a blood glucose level that is elevated after 120 min in a standard 75‑g oral glucose tolerance test, or both. The American Diabetes Association definition also includes glycated hemoglobin A (HbA1c). The incidence of prediabetes is rapidly increasing. Progression from normal glucose tolerance to diabetes is a continuous process. Insulin resistance and insulin secretory dysfunction, the simultaneous presence of which characterizes manifest diabetes, are already present in the prediabetic stage. Prediabetes is associated with an increased risk of diabetes; however, by no means all people with prediabetes go on to develop diabetes. Nevertheless, the identification of an increased risk of diabetes is still relevant insofar as it requires the adoption of diabetes prevention measures. Structured lifestyle intervention has been shown to be the most effective strategy for treating prediabetes. To increase its efficiency, it should, as far as possible, be made exclusively available to those people on whom it is most likely to confer a benefit. This would make it necessary to stratify people with prediabetes according to their risk profile. In a population of people at increased risk of diabetes (Tübingen Diabetes Family Study), a cluster analysis was performed, resulting in six clusters/subgroups. Within these, three high-risk subgroups were identified: Two of these risk groups show predominant insulin secretory dysfunction or predominant insulin resistance and high diabetes and cardiovascular risk. The third group shows a high risk of nephropathy and high mortality, but a comparatively lower diabetes risk. In general, prediabetes cannot yet be treated in a targeted pathophysiologically oriented manner. The new classification of prediabetes—based on pathophysiology—is now opening up new avenues for diabetes prevention. Current and future studies should confirm the assumption that the effectiveness of established, or not yet established, preventive measures depends on the respective subgroup.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Review
Schlagwörter Cardiovascular Risk ; Impaired Insulin Secretion ; Insulin Resistance ; Lifestyle Intervention ; Risk Stratification; Life-style Intervention; Impaired Glucose-tolerance; Risk; Pathophysiology; Individuals; Reduction; Diagnosis; Glycemia
Sprache deutsch
Veröffentlichungsjahr 2023
HGF-Berichtsjahr 2023
ISSN (print) / ISBN 2731-7080
e-ISSN 2731-7099
Zeitschrift Innere Medizin
Quellenangaben Band: 64, Heft: 7, Seiten: 636-641 Artikelnummer: , Supplement: ,
Verlag Springer
Verlagsort Heidelbergerplatz 3, Berlin, Germany
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Diabetes Research and Metabolic Diseases (IDM)
POF Topic(s) 90000 - German Center for Diabetes Research
Forschungsfeld(er) Helmholtz Diabetes Center
PSP-Element(e) G-502400-001
DOI 10.1007/s00108-023-01546-6
WOS ID 001012266800001
Scopus ID 85168342290
PubMed ID 37328664
Erfassungsdatum 2023-12-05
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