Читать книгу Clinical Dilemmas in Diabetes - Группа авторов - Страница 14

Prediabetes is defined as an elevated fasting plasma glucose (FPG), and/or an elevated 2‐hour plasma glucose (2‐h PG) during a 75‐gram (g) oral glucose tolerance test (OGTT), and/or an elevated Hemoglobin A1c (HbA1c), without meeting diagnostic criteria for overt diabetes mellitus (DM) [1]. The 2020 American Diabetes Association (ADA) Guidelines define prediabetes as impaired fasting glucose (IFG) with a FPG of 100–125 mg/dL, and/or impaired glucose tolerance (IGT) with a 2‐h PG during a 75‐g OGTT of 140–199 mg/dL, and/or a HbA1c of 5.7–6.4% [1]. In contrast to the ADA, the 2016 World Health Organization (WHO) Guidelines define intermediate hyperglycemia as IFG between 110–125 mg/dL and/or IGT with a 2‐h PG during a 75‐g OGTT between 140–199 mg/dL [2]. Unlike the ADA, the WHO does not include HbA1c as a diagnostic criterion for prediabetes.

The definitions of both prediabetes and DM have evolved in recent decades. The WHO first defined the “borderline state” in 1965 as a 2‐h PG during a 50 or 100 g OGTT between 110–129 mg/dL [3]. The ADA has long recognized IGT, and its definition has undergone little change since its inception. First adopted by the ADA in 1997 and WHO in 1999, the term IFG was originally defined as FPG 110–125 mg/dL [4]. However, in 2003, the ADA revised the criteria for IFG to 100–125 mg/dL based on data from multiple studies showing that the risk of DM increases markedly at a FPG concentration > 100 mg/dL [5]. In 2010, the ADA added HbA1c as a diagnostic criterion for prediabetes because the relationship between HbA1c and the risk of retinopathy was similar to corresponding FPG and 2‐h PG thresholds [6].