Prediabetes is a window of opportunity for preventive interventions. Part 1

Prediabetes (PD) is a prominent example of conditions known as pre-existing disease in modern clinical medicine. The prevalence of carbohydrate metabolism disorders increases every year. Pathophysiological changes in prediabetes are numerous and are represented, among other things, at the genetic level, the so-called “metabolic memory”. Already at the prediabetes stage, changes in various organs and systems characteristic of hyperglycemia begin to form. The purpose of the review is to present modern data on the epidemiology, pathobiology of prediabetes, and its complications. The article presents statistical and prognostic data on the prevalence of prediabetes, provides epidemiological data for Russia and the world, and discusses modern ideas about the transformation of early carbohydrate metabolism disorders into diabetes. A large section is devoted to the description of the pathophysiology of complications of long-term hyperglycemia from the cardiovascular system, liver, reproductive system, kidneys, and oncogenesis. The pathophysiological and clinical features of early carbohydrate metabolism disorders – impaired fasting glycemia and impaired glucose tolerance – are presented. The article discusses the mechanisms of metabolic memory development and its role in the development of early complications of prediabetes. The data of the latest studies studying the pathogenesis of organ damage in prediabetes are analyzed – the mechanisms of fatty liver disease development, risk factors for oncogenesis, reproductive disorders, the mechanisms of cellular aging in prediabetes, microvascular and macrovascular complications with the development of cardiovascular diseases, the pathobiology of nephropathy are considered. The analysis of modern epidemiological and prognostic data, the results of fundamental and clinical studies confirms the relevance of the problem of early diagnosis of prediabetes and substantiates the need for active therapeutic tactics.

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