Pathophysiology of prediabetes

Med Clin North Am. 2011 Mar;95(2):327-39, vii-viii. doi: 10.1016/j.mcna.2010.11.005.


Prediabetes encompasses conventional diagnostic categories of impaired fasting glucose and impaired glucose tolerance but is a band of glucose concentrations and a temporal phase over a continuum extending from conventional normal glucose tolerance to overt type 2 diabetes. Insulin resistance and defective glucose sensing at the β-cell are the central pathophysiologic determinants that together cause hyperglycemia. Regardless of the cellular origin of insulin resistance, excessive tissue fat utilization is a consistent metabolic mechanism. Although genetic influences affect β-cell function, becoming overweight is the main acquired challenge to insulin action. The phenotype of prediabetes includes dyslipidemia and higher arterial blood pressure.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology
  • Glucagon / metabolism
  • Glucose / metabolism*
  • Humans
  • Insulin Resistance
  • Insulin-Secreting Cells / metabolism
  • Lipids / blood
  • Liver / metabolism
  • Prediabetic State / metabolism
  • Prediabetic State / physiopathology*
  • Risk Factors


  • Blood Glucose
  • Lipids
  • Glucagon
  • Glucose