Organisational and practical aspects of managing outpatients with prediabetes: an interaction between practitioners and public health officials. Expert Council Resolution

The document represents an expert consensus on the organizational and practical aspects of managing outpatients with prediabetes. The resolution emphasized the importance of timely detection and outpatient monitoring of individuals with carbohydrate metabolism disorders. We discussed diagnostics using various methods (fasting plasma glucose, HbA1c, oral glucose tolerance test), and the need to integrate the Finnish Diabetes Risk Score (FINDRISC) into the practice of preventive and outpatient monitoring examinations. The experts noted the lack of regulatory framework for prediabetes and emphasized the need to develop an interdisciplinary consensus on this condition. Proposals were made to amend statistical data forms, include prediabetes in the outpatient monitoring system, and develop a separate charge for in-depth preventive counseling. The discussion ended with the development of a set of proposals aimed at increasing the effectiveness of prevention, early diagnosis and medical monitoring of patients with prediabetes.

1. Zilov AV. Prediabetes: current state of the problem and clinical recommendations. Effective pharmacotherapy. 2022;18(30):20-6. (In Russ.) doi:10.33978/2307-3586-2022-18-30-20-26.

2. Echouffo-Tcheugui JB, Perreault L, Ji L, Dagogo-Jack S. Diagnosis and Management of Prediabetes: A Review. JAMA. 2023;329(14):1206-16. doi:10.1001/jama.2023.4063.

3. Vajravelu ME, Lee JM. Identifying Prediabetes and Type 2 Diabetes in Asymptomatic Youth: Should HbA1c Be Used as a Diagnostic Approach? Curr Diab Rep. 2018;18(7):43. doi:10.1007/s11892-018-1012-6.

4. Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. doi:10.1016/j.diabres.2021.109119.

5. Dedov I, Shestakova M, Galstyan G, et al. The prevalence of type 2 diabetes mellitus (T2DM) in the adult Russian population (NATION study). Diabetes Res Clin Pract. 2016;115:90-5.

6. Drapkina OM, Drozdova LYu, Shepel RN, et al. Analysis of prediabetes prevalence and real-world practice in prescribing drug therapy to prediabetic patients. Russian Journal of Preventive Medicine. 2022;25(12):96105. (In Russ.) doi:10.17116/profmed20222512196.

7. Haw JS, Galaviz KI, Straus AN, et al. Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. 2017;177(12):1808-17. doi:10.1001/jamainternmed.2017.6040.

8. Kerrison G, Gillis RB, Jiwani SI, et al. The Effectiveness of Lifestyle Adaptation for the Prevention of Prediabetes in Adults: A Systematic Review. J Diabetes Res. 2017;2017:8493145. doi:10.1155/2017/8493145.

9. Richter B, Hemmingsen B, Metzendorf MI, Takwoingi Y. 2018. Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia. Cochrane Database Syst. Rev. 10(10):CD012661.

10. Dedov II, Shestakova MV, Vikulova OK, et al. Diabetes mellitus in the Russian Federation: dynamics of epidemiological indicators according to the Federal Register of Diabetes Mellitus for the period 2010-2022. Diabetes mellitus. 2023;26(2):104-23. (In Russ.) doi:10.14341/DM13035.

11. Sineglazova AV, Fakhrutdinova ASh. Changes of carbohydrate metabolism and insulin resistance parameters at different compliance levels in young people. Cardiovascular Therapy and Prevention. 2024;23(6):4059. (In Russ.) doi:10.15829/1728-8800-2024-4059.

12. Balanova YuA, Shalnova SA, Imaeva AE, et al. Risk stratification of type 2 diabetes in the Russian population depending on FINDRISC category: results of prospective follow-up. Cardiovascular Therapy and Prevention. 2024;23(6):3967. (In Russ.) doi:10.15829/1728-8800-2024-3967.

13. Emerging Risk Factors Collaboration; Sarwar N, Gao P, Seshasai SR, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215-22. doi:10.1016/S0140-6736(10)60484-9. Erratum in: Lancet. 2010;376(9745):958.

14. Selvin E, Lazo M, Chen Y, et al. Diabetes mellitus, prediabetes, and incidence of subclinical myocardial damage. Circulation. 2014;130(16):1374-82. doi:10.1161/CIRCULATIONAHA.114.010815.

15. Choi D, Choi S, Son JS, et al. Impact of Discrepancies in General and Abdominal Obesity on Major Adverse Cardiac Events. J Am Hear Assoc. 2019;8(18):e013471. doi:10.1161/JAHA.119.013471.