Prediabetes: An Update and a Rational for Diagnostic Confusion

Abstract

The aim of this review is to increase awareness for prediabetes and help diagnose maximum number of prediabetic patients with minimum number of tests for physicians and health care workers. Prediabetes is a significant health problem because it can cause microvascular and macrovascular complications, accompany metabolic syndrome and predict the development of diabetes. It is common worldwide; however, most patients cannot be diagnosed because single tests used for scanning it have low diagnostic value alone. In addition; different definitions released by different organizations increase the clinicians’ concept of confusion. As a result; developing complications in initially undiagnosed patients call for greater efforts and costs. Therefore: an early and correct diagnosis of prediabetes is important. It is not rational to increase the number of tests for every case considering increased costs. According to this; classification of cases depending on risk status would be correct to assess the tests for scanning. The risk stratification is also discussed. Primary care physicians need to have a good understanding of screening for prediabetes as a core competency and to serve proactively.

 

Bu derlemenin amacı hekimlerin prediyabet farkındalığını artırmak ve en az sayıda test ile en fazla sayıda prediyabetik hastanın teşhis edilmesine yardımcı olmaktır. Prediyabet mikrovasküler ve makrovasküler komplikasyonlar oluşturması, metabolik sendroma eşlik etmesi ve diyabet gelişimini öngürdürmesi açısından önemli bir sağlık sorunudur. Dünyada oldukça yaygın olup tek bir testle tanısal değeri düşük olduğu için hastaların çoğu teşhis alamamaktadır. Ek olarak değişik çalışma gruplarının ortaya koyduğu değişik yaklaşımlar klinisyenlerin konsept karmaşasını artırmaktadır. Sonuç olarak erken dönemde teşhis edilememiş hastalarda gelişen komplikasyonlar daha fazla çaba ve maliyete sebep olur. Bu yüzden prediyabetin erken ve doğru teşhisi gereklidir. Maliyetler gözönüne alındığında prediyabet teşhisine yönelik her hasta için çok sayıda test istenmesi de akla yakın gözükmemektedir. Buna göre; tanı için gerekli testlerin belirlenmesinde vakaların sahip olduları risk durumuna göre sınıflandırılması doğru olacaktır. Risk belirlenmesi konu içinde tartışılmıştır. Birinci basamak hekimlerinin prediyabete yönelik yeterliliklerinin sağlanması koruyucu hekimlik hizmeti sunmalarının da önünü açacaktır. 

Keywords

• Prediabetes,screening tests

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