Metabolic syndrome is defined as cluster of independent risk factors of coronary heart disease and type 2 diabetes mellitus including prediabetic glucose metabolism disorders associated with insulin resistance as impaired fasting glucose, impaired glucose tolerance and/ or borderline increasing of glycosylated haemoglobin; central obesity, atherogenic dyslipidaemia with increasing of triglyceride levels and decreasing of high density lipoprotein levels and hypertension. In diagnosis of prediabetic states there are used fasting glycaemia, 2 hours glycaemia during oral glucose tolerant test and HbA1c level, which importance in diagnostic is discussed. In DM2 prevention there is important mainly physical activity at least 30 min daily. In the case of pharmacotherapy there was confirmed efficiency of metformin, which could be used in states with high risk of DM2 conversion and some antihypertensive drugs, mainly sartans. In the case of treatment of dyslipidaemia by statins there is moderate increased risk of DM2 in prediabetic states, but cardiovascular benefit from treatment some times exceeds this risk.