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

Abstract

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

Disclosure

AAb and AE are employees of Merck Serono Middle East FZ-Ltd, an affiliate of Merck KGaA, Darmstadt, Germany. Other authors of this manuscript have acted as consultants for Merck Serono Middle East FZ-Ltd, and declared no additional duality of interest.

Additional information

Funding

Merck Serono Middle East FZ-Ltd funded open access publication and editorial support (see below). No other funding applied. Authors remained in complete control of the content of the article throughout. A medical writer (Dr Mike Gwilt, GT Communications) provided editorial support, funded by Merck Serono Middle East FZ-Ltd.