Prediabetes and Cardiovascular Disease: Pathophysiology and Interventions for Prevention and Risk Reduction

Endocrinol Metab Clin North Am. 2018 Mar;47(1):33-50. doi: 10.1016/j.ecl.2017.10.001.


Prediabetes is a state characterized by impaired fasting glucose or impaired glucose tolerance. This review discusses the pathophysiology and macrovascular complications of prediabetes. The pathophysiologic defects underlying prediabetes include insulin resistance, alpha- and beta-cell dysfunction, increased lipolysis, inflammation, and suboptimal incretin effect. Recent studies have revealed that the long-term complications of diabetes manifest in some people with prediabetes; these complications include microvascular and macrovascular disorders. Finally, we present an overview of randomized control trials aimed at preventing progression from prediabetes to type 2 diabetes and discuss their implications for macrovascular risk reduction.

Keywords: Cardiovascular disease; Impaired fasting glucose; Impaired glucose tolerance; Macrovascular; Prediabetes complications.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / metabolism
  • Cardiovascular Diseases* / prevention & control
  • Diabetes Mellitus, Type 2* / etiology
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / prevention & control
  • Disease Progression*
  • Humans
  • Prediabetic State* / complications
  • Prediabetic State* / metabolism
  • Prediabetic State* / therapy
  • Risk Reduction Behavior*