Prediabetes is a window of opportunity for preventive interventions. Part 2

Early disorders of carbohydrate metabolism, due to their high prevalence, are an urgent clinical problem. Many studies indicate a low awareness of primary care physicians about the criteria for diagnosis and approaches to the treatment of prediabetes. However, it is at the stage of prediabetes that changes in various organs and systems characteristic of hyperglycemia begin to form. Early diagnosis and initiation of therapy will improve the quality of life, prevent complications, delay or prevent the development of diabetes mellitus. The purpose of the review is to provide up–to-date data on the diagnosis and treatment of prediabetes. The criteria for disorders of carbohydrate metabolism were described in the 1970s–80s, but a universal approach to diagnosing prediabetes is still lacking. A number of contentious issues remain: whether this condition is truly a stage in the development of diabetes, which diagnostic method to choose, whether lifestyle modifications are sufficient or if drug therapy should be initiated, and which therapeutic method to select. A total of 37 articles were analyzed, including data from randomized controlled trials (RCTs) and 2024 guidelines. The modern physician’s toolkit includes the possibility of pharmacological prevention of type 2 diabetes mellitus using the drug Subetta. This biological agent is created based on affinity-purified antibodies to the C-terminal fragment of the insulin receptor β-subunit and to endothelial NO-synthase. It has a pleiotropic mechanism of action: it increases cell sensitivity to insulin, thereby providing the drug’s hypoglycemic effect. Further information is needed for physicians about various specialties, the risks of developing various organs and systems at the prediabetic stage, and the introduction of active screening and therapy methods.