Prediabetes, a condition where the blood sugar is too high for optimal cellular function but not high enough to be labeled diabetes, is a silent killer – a precursor to the dreaded heart attack. Prediabetes is not just a warning phase; it is an active disease state where the root cause should be sought out and treated as an active contributor to the heart disease process and where focus on preventing diabetes should be put on the shelf.
The very presence of prediabetes poses a prognostic indicator of future fatal cardiovascular events over normoglycemia by threefold!
And, in those suffering from metabolic syndrome, even minor increases in glycemic control places patients at a high risk for cardiovascular mortality in contrast to other disease variables such as HDL level or hypertension. Even a mild increase in fasting glycemia in metabolic syndrome patients dramatically increased their risk for adverse heart events by 38%.
Prediabetes is also involved in the onset of mild cognitive impairment and, possibly, Alzheimer’s disease.
The prevalence of prediabetes in ischemic stroke patients is high, and it may be necessary to prescribe pharmacological treatment to prevent the patients from post-stroke cognitive impairment. Significant longitudinal associations between HbA1c levels, diabetes status, and long-term cognitive decline were observed in a study of 5,189 participants linking blood sugar control and cognitive impairment. But it doesn’t stop here. Another study examined the relationship between blood sugar control and the increased risk for Alzheimer’s disease.
While data is conflicting on hospitalizations related to cardiac mortality relative to prediabetes status, prediabetes was associated with a higher risk of in-hospital and long-term mortality among people with infective endocarditis in at least one study of over 800 adults.
To make this scenario even worse, prediabetes is common in patients with acute coronary syndrome (ACS) who are not previously known to have diabetes.
Prediabetic patients had worse in-hospital clinical outcomes compared to patients without diabetes. The point here is that prior to hospitalization for ACS, they had no knowledge that they had a blood sugar problem, a travesty affecting some 7 million adults today in the US.
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