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

Pathophysiology of prediabetes.

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Department of Internal Medicine, University of Pisa School of Medicine, Via Roma, 67, 56100 Pisa, Italy.


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.

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