Diabetes, Metabolic Syndrome and Obesity (Jan 2023)

Addressing the Continuum of Dysglycaemia and Vascular Complications in Prediabetes and Type 2 Diabetes: Need for Early and Intensive Treatment

  • Ghannam N,
  • Alahmed S,
  • Aldahash R,
  • Aljohani N,
  • Alshammary A,
  • Amir A,
  • Kamal A,
  • Khader S,
  • Salah M,
  • Shalabi H,
  • Abdallah A,
  • Elboghdady A

Journal volume & issue
Vol. Volume 16
pp. 105 – 115

Abstract

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Nadia Ghannam,1 Saleh Alahmed,2 Raed Aldahash,3 Naji Aljohani,4 Afaf Alshammary,5 Ashraf Amir,6 Abdullah Kamal,7 Said Khader,8 Mohammed Salah,9 Hani Shalabi,10,11 Ahmed Abdallah,12 Ahmed Elboghdady12 1Ghannam Clinic, Jeddah, Saudi Arabia; 2Almana Group of Hospitals, Dammam, Saudi Arabia; 3Ministry of National Guard (Health Affairs) and King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 4King Fahad Medical City, Riyadh, Saudi Arabia; 5Ministry of National Guard (Health Affairs), King Abdulaziz Medical City, Riyadh and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 6Family Medicine International Medical Center, Jeddah, Saudi Arabia; 7Dallah Hospital, Riyadh, Saudi Arabia; 8Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia; 9Cairo University, Cairo, Egypt and GNP Hospital, Jeddah, Saudi Arabia; 10University of Jeddah, Jeddah, Saudi Arabia; 11Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 12Merck Serono Middle East FZ-Ltd, Jeddah, Saudi ArabiaCorrespondence: Nadia Ghannam, Ghannam Clinic, King Abdulaziz Road, Jeddah, 21411, Saudi Arabia, Email [email protected]: The onset of type 2 diabetes increases the risk of vascular complications and death. We know now that that this risk begins long before the diabetes diagnosis. Prediabetes and type 2 diabetes are not separate entities in practice and exist within a continuum of dysglycaemia and vascular risk that increases in severity over time. This excess risk requires early intervention with lifestyle therapy supported with pharmacologic antidiabetic therapy, intensified promptly where necessary throughout the duration of the diabetes continuum. Metformin is an evidence-based treatment for preventing prediabetes and improves cardiovascular outcomes in people with type 2 diabetes from diagnosis onwards. Newer agents (SGLT2 inhibitors and GLP-1 agonists) are appropriate for people presenting with type 2 diabetes and significant cardiovascular comorbidity. Additional therapies should be used without delay to achieve patients’ individualised HbA1c goals and to minimise cardiovascular risk.Keywords: prediabetes, type 2 diabetes, diabetes complications, antidiabetic therapy

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