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