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Abstract
The increasing prevelance of diabetes mellitus and its complication in the last decades alarms most of international committee and association e.g, ADA, WHO, AACE etc. For early prevention and management of diabetes the term prediabetes rebirthed again to describe patients with IGT &IFG which are intermediate metabolic state between normal and diabetic glucose haemostasis.
IGT; in which 2h plasma glucose is more than 140 mg/dl and less than 200mg/dl (i.e 7.8 – 11 mmol/L), while IFG means that fasting blood sugar is more than 100mg/dl and less than 126mg/dl (i.e 5.5 -7 mmol/L).Screening programs for D.M. & prediabetes should include people with high risk for developing D.M. e.g aged > 45 years, BMI > 25 and past history of prediabetes.
Metabolic disturbance is the iceberg of this stage. Alot of metabolic disturbances preceed occurance of diabetes and even prediabetes which play fundamental role in occurance of complication in this stage.Disturbed lipid metabolism; poor lipid profile ,increase the oxidized LDL hasten the athrothrombosis in these patient.adiponectin and other protiens secreated by adipocytes are the recent aggressors which are strongly related to insulin resistance. A developing literature links pre-diabetes to complications that traditionally are attributed to diabetes. These complications include both macrovascular (myocardial infarction and stroke), and microvascular disease as retinopathy, microalbuminuria, and polyneuropathy. The retinopathy said to be linked to the prediabetic states have all been of background diabetic retinopathy.