Pathophysiological insights: insulin resistance and β-cell dysfunction as early markers of pre-diabetes

Background: Pre-diabetes represents a critical intermediate state of dysglycaemia where both insulin resistance (IR) and β-cell dysfunction (β-CD) contribute to progression toward type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study was conducted among 300 adults, divided into normal glucose tolerance (GT) (control n being 100), pre-T2DM (n being 120), and T2DM (n being 80) groups. Anthropometric and clinical measurements were documented, and biochemical assays were employed to calculate indices of IR (HOMA-IR, QUICKI, Matsuda index) and β-cell function (β-CF) (HOMA-β, insulinogenic index, disposition index, C-peptide). Logistic regression determined predictors of pre-T2DM, whereas ROC analysis evaluated discriminative efficacy. Results: Participants with pre-T2DM and T2DM had greater BMI, waist circumference, and systolic blood pressure than NGT controls (p