Abstract

Prediabetes is an intermediate state of hyperglycemia with glycemic parameters above normal but below the diabetes threshold. Prediabetes is a state characterized by impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). While, the diagnostic criteria of prediabetes are not uniform across various international professional organizations, Prediabetes remains a state of high risk for developing diabetes with yearly conversion rate of 5%-10%. Observational evidence suggests as association between prediabetes and complications of diabetes such early diabetic nephropathy, diabetic neuropathy, early diabetic retinopathy and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes. A better understanding of prediabetes could help with earlier identification, thereby allowing earlier intervention, potentially lowering the number of individuals who go on to develop diabetes and diabetic complications. Preventing progression from prediabetes to type 2 diabetes by the lifestyle intervention and pharmacologic agents (metformin, a-glucosidase inhibitors, glucagonlike peptide 1 receptor agonists, thiazolidinediones). Use of drugs requires consideration of cost, side effects, and durable efficacy. Metformin has the strongest evidence base and demonstrated long-term safety as pharmacologic therapy for diabetes prevention. Based on findings from the Diabetes Prevention Program (DPP), Metformin should be recommended as an option for high-risk individuals (e.g., those with a history of Gestational Diabetes Mellitus, < 60 years olds,  BMI ≥25 kg/m2 for Asian people, one of risk factors (HbA1c > 6%, IFG plus IGT, high blood pressure, HDL.C < 0,9 mmol/L, TG > 2,52 mmol and First-degree relative with diabetes)