1

Prediabetes

Burden

2

Epidemiology: Health Performance Gaps

• Prevalence• Risk factors

– Metabolic syndrome– Obesity

• Clinical risks of prediabetes– Progression to diabetes

• Complications (eg, retinopathy)

3

Impaired Glucose

Tolerance

Impaired Fasting Glucose

Diabetes

Progression to Type 2 Diabetes

Or both

Prediabetes

4

2007 20100

20

40

60

80

100

120

5779

17.9

18.85.7

7.0

Undiagnosed DiabetesDiagnosed Di-abetesPrediabetes

Prevalence of Diabetes and Prediabetes in the United States

CDC and Prevention. National diabetes fact sheet, 2007. http://www.cdc.gov/Diabetes/pubs/pdf/ndfs_2007.pdf.CDC and Prevention. National diabetes fact sheet, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf.

Prediabetes

35% of US population

Diabetes

8.3% of US population

Per

son

s (m

illio

ns)

39% increase

Increased incidence of prediabetes from 2007 to 2010

5

Incidence of prediabetes, IFG, and IGT in a representative sample of the US population

Prevalence of IFG and IGT in US Adults Without T2DM: NHANES Data

Prediabetes IFG only IGT only IFG and IGT0%

5%

10%

15%

20%

25%

30%

35%

40%34.6%

19.4%

5.4%

9.8%

IFG, impaired fasting glucose; IGT, impaired glucose tolerance; NHANES, National Health and Nutrition Examination Survey ; T2DM , type 2 diabetes mellitus.

Karve A, Hayward RA. Diabetes Care. 2010;33:2355-2359.

6

How Much Does the Metabolic Syndrome Raise the Risk of T2DM?

IFG, impaired fasting glucose; MetSyn, metabolic syndrome; T2DM, type 2 diabetes mellitus.Lorenzo C, et al. Diabetes Care. 2007;30:8-13.

1.0

5.0

10.0

20.0

25.0

MetSynwithout

IFG

IFGwithoutMetSyn

MetSyn+

IFG

No MetSynNo IFG

Od

ds

Rat

io (

Con

fiden

ce In

terv

al)

5.03(3.39-7.48)

21.0(13.1-33.8)

7.07(3.32-15.1)

1.0(ref)

T2DM risk, stratified by IFG and metabolic syndrome