JCNRJournal of Clinical and Nursing Research2208-36852208-3693Bio-Byword Scientific Publishing Pty. Ltd.10.26689/jcnr.v8i12.9311ArticleEvaluation and Intervention Methods for Patients with Prediabetes of Different Phenotypeshttps://artdesignp.com/journal/JCNR/8/12/10.26689/jcnr.v8i12.9311ZhaZhenghui,ZhangYuli,WangSongtao20258122025-01-07Prediabetes is a heterogeneous condition, encompassing various pathological phenotypes such as hyperinsulinemia, tissue-specific insulin resistance (IR), systemic IR, and β-cell dysfunction. A significant proportion of individuals with prediabetes remain undiagnosed. Furthermore, although lifestyle interventions have demonstrated efficacy in improving prediabetic conditions, some individuals with prediabetes progress to type 2 diabetes mellitus. This study aims to summarize effective evaluation methods for identifying distinct pathological phenotypes of prediabetes and targeted lifestyle intervention strategies to mitigate the progression from prediabetes to diabetes.

GBD 2021 Diabetes Collaborators, 2023, Global, Regional, and National Burden of Diabetes from 1990 to 2021, with Projections of Prevalence to 2050: A Systematic Analysis for the Global Burden of Disease Study 2021. Lancet, 402(10397): 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6. Erratum in Lancet, 402(10408): 1132. https://doi.org/10.1016/S0140-6736(23)02044-5

Zhang Y, Shen T, Wang S, 2022, Progression from Prediabetes to Type 2 Diabetes Mellitus Induced by Overnutrition. Hormones (Athens), 21(4): 591–597. https://doi.org/10.1007/s42000-022-00399-2

Centers for Disease Control and Prevention (CDC), 2013, Awareness of Prediabetes–United States, 2005–2010. MMWR Morb Mortal Wkly Rep, 62(11): 209–212.

DeFronzo RA, Tobin JD, Andres R, 1979, Glucose Clamp Technique: A Method for Quantifying Insulin Secretion and Resistance. Am J Physiol, 237(3): E214–E223. https://doi.org/10.1152/ajpendo.1979.237.3.E214

DeFronzo RA, Simonson D, Ferrannini E, 1982, Hepatic and Peripheral Insulin Resistance: A Common Feature of Type 2 (Non-Insulin-Dependent) and Type 1 (Insulin-Dependent) Diabetes Mellitus. Diabetologia, 23(4): 313–319. https://doi.org/10.1007/BF00253736

Faerch K, Borch-Johnsen K, Holst JJ, et al., 2009, Pathophysiology and Aetiology of Impaired Fasting Glycaemia and Impaired Glucose Tolerance: Does It Matter for Prevention and Treatment of Type 2 Diabetes? Diabetologia, 52(9): 1714–1723. https://doi.org/10.1007/s00125-009-1443-3

Magkos F, Mittendorfer B, 2009, Stable Isotope-Labeled Tracers for the Investigation of Fatty Acid and Triglyceride Metabolism in Humans In Vivo. Clin Lipidol, 4(2): 215–230. https://doi.org/10.2217/clp.09.9

Li C, Ford ES, McGuire LC, et al., 2006, Trends in Hyperinsulinemia Among Nondiabetic Adults in the U.S. Diabetes Care, 29(11): 2396–2402. https://doi.org/10.2337/dc06-0289

Rijkelijkhuizen JM, McQuarrie K, Girman CJ, et al., 2010, Effects of Meal Size and Composition on Incretin, Alpha-Cell, and Beta-Cell Responses. Metabolism, 59(4): 502–511. https://doi.org/10.1016/j.metabol.2009.07.039

Kolb H, Kempf K, Röhling M, et al., 2020, Insulin: Too Much of a Good Thing is Bad. BMC Med, 18(1): 224. https://doi.org/10.1186/s12916-020-01688-6

Ten S, Maclaren N, 2004, Insulin Resistance Syndrome in Children. J Clin Endocrinol Metab, 89(6): 2526–2539. https://doi.org/10.1210/jc.2004-0276

Bonnet-Serrano F, Devin-Genteuil C, Thomeret L, et al., 2023, C-Peptide Level Concomitant with Hypoglycemia Gives Better Performances than Insulin for the Diagnosis of Endogenous Hyperinsulinism: A Single-Center Study of 159 Fasting Trials. Eur J Endocrinol, 188(2): lvad012. https://doi.org/10.1093/ejendo/lvad012

Gastaldelli A, 2022, Measuring and Estimating Insulin Resistance in Clinical and Research Settings. Obesity (Silver Spring), 30(8): 1549–1563. https://doi.org/10.1002/oby.23503

Gastaldelli A, Baldi S, Pettiti M, et al., 2000, Influence of Obesity and Type 2 Diabetes on Gluconeogenesis and Glucose Output in Humans: A Quantitative Study. Diabetes, 49(8): 1367–1373. https://doi.org/10.2337/diabetes.49.8.1367

Ferrannini E, Groop LC, 1989, Hepatic Glucose Production in Insulin-Resistant States. Diabetes Metab Rev, 5(8): 711–726. https://doi.org/10.1002/dmr.5610050806

Bergman M, Abdul-Ghani M, DeFronzo RA, et al., 2020, Review of Methods for Detecting Glycemic Disorders. Diabetes Res Clin Pract, 165: 108233. https://doi.org/10.1016/j.diabres.2020.108233. Erratum in Diabetes Res Clin Pract, 180: 108632. https://doi.org/10.1016/j.diabres.2020.108632

Gastaldelli A, Harrison SA, Belfort-Aguilar R, et al., 2009, Importance of Changes in Adipose Tissue Insulin Resistance to Histological Response During Thiazolidinedione Treatment of Patients with Nonalcoholic Steatohepatitis. Hepatology, 50(4): 1087–1093. https://doi.org/10.1002/hep.23116

Søndergaard E, Espinosa De Ycaza AE, Morgan-Bathke M, et al., 2017, How to Measure Adipose Tissue Insulin Sensitivity. J Clin Endocrinol Metab, 102(4): 1193–1199. https://doi.org/10.1210/jc.2017-00047

Ter Horst KW, van Galen KA, Gilijamse PW, et al., 2017, Methods for Quantifying Adipose Tissue Insulin Resistance in Overweight/Obese Humans. Int J Obes (Lond), 41(8): 1288–1294. https://doi.org/10.1038/ijo.2017.110

Ferrannini E, Bjorkman O, Reichard GA Jr, et al., 1985, The Disposal of an Oral Glucose Load in Healthy Subjects. A Quantitative Study. Diabetes, 34(6): 580–588. https://doi.org/10.2337/diab.34.6.580

Abdul-Ghani MA, Matsuda M, Balas B, et al., 2007, Muscle and Liver Insulin Resistance Indexes Derived from the Oral Glucose Tolerance Test. Diabetes Care, 30(1): 89–94. https://doi.org/10.2337/dc06-1519

Van der Kolk BW, Vogelzangs N, Jocken JWE, et al., 2019, Plasma Lipid Profiling of Tissue-Specific Insulin Resistance in Human Obesity. Int J Obes (Lond), 43(5): 989–998. https://doi.org/10.1038/s41366-018-0189-8

Van der Kolk BW, Kalafati M, Adriaens M, et al., 2019, Subcutaneous Adipose Tissue and Systemic Inflammation Are Associated With Peripheral but Not Hepatic Insulin Resistance in Humans. Diabetes, 68(12): 2247–2258. https://doi.org/10.2337/db19-0560

Song Y, Manson JE, Tinker L, et al., 2007, Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Risk of Diabetes in a Multiethnic Cohort of Women: The Women’s Health Initiative Observational Study. Diabetes Care, 30(7): 1747–1752. https://doi.org/10.2337/dc07-0358

Matsuda M, DeFronzo RA, 1999, Insulin Sensitivity Indices Obtained from Oral Glucose Tolerance Testing: Comparison with the Euglycemic Insulin Clamp. Diabetes Care, 22(9): 1462–1470. https://doi.org/10.2337/diacare.22.9.1462

Reaven GM, Hollenbeck CB, Chen YD, 1989, Relationship Between Glucose Tolerance, Insulin Secretion, and Insulin Action in Non-Obese Individuals with Varying Degrees of Glucose Tolerance. Diabetologia, 32(1): 52–55. https://doi.org/10.1007/BF00265404

Ahrens B, Taborsky G Jr., 2002, B-Cell Function and Insulin Secretion, in Baron A, Porte D, Sherwin RS (eds), Ellenberg and Rifkin’s Diabetes Mellitus. McGraw-Hill Professional, New York, 43–65.

Defronzo RA, 2009, Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes, 58(4): 773–795. https://doi.org/10.2337/db09-9028

Wallace TM, Levy JC, Matthews DR, 2004, Use and Abuse of HOMA Modeling. Diabetes Care, 27(6): 1487–1495. https://doi.org/10.2337/diacare.27.6.1487

Stefan N, Fritsche A, Schick F, et al., 2016, Phenotypes of Prediabetes and Stratification of Cardiometabolic Risk. Lancet Diabetes Endocrinol, 4(9): 789–798. https://doi.org/10.1016/S2213-8587(16)00082-6

Oosterman JE, Wopereis S, Kalsbeek A, 2020, The Circadian Clock, Shift Work, and Tissue-Specific Insulin Resistance. Endocrinology, 161(12): bqaa180. https://doi.org/10.1210/endocr/bqaa180

Hall KD, Chen KY, Guo J, et al., 2016, Energy Expenditure and Body Composition Changes After an Isocaloric Ketogenic Diet in Overweight and Obese Men. Am J Clin Nutr, 104(2): 324–333. https://doi.org/10.3945/ajcn.116.133561

Ludwig DS, Ebbeling CB, 2018, The Carbohydrate-Insulin Model of Obesity: Beyond “Calories In, Calories Out”. JAMA Intern Med, 178(8): 1098–1103. https://doi.org/10.1001/jamainternmed.2018.2933

Barnosky AR, Hoddy KK, Unterman TG, et al., 2014, Intermittent Fasting vs Daily Calorie Restriction for Type 2 Diabetes Prevention: A Review of Human Findings. Transl Res, 164(4): 302–311. https://doi.org/10.1016/j.trsl.2014.05.013

Trussardi Fayh AP, Lopes AL, Fernandes PR, et al., 2013, Impact of Weight Loss With or Without Exercise on Abdominal Fat and Insulin Resistance in Obese Individuals: A Randomised Clinical Trial. Br J Nutr, 110(3): 486–492. https://doi.org/10.1017/S0007114512005442

Tremblay A, Pelletier C, Doucet E, et al., 2004, Thermogenesis and Weight Loss in Obese Individuals: A Primary Association with Organochlorine Pollution. Int J Obes Relat Metab Disord, 28(7): 936–939. https://doi.org/10.1038/sj.ijo.0802527

Melanson KJ, Summers A, Nguyen V, et al., 2012, Body Composition, Dietary Composition, and Components of Metabolic Syndrome in Overweight and Obese Adults After a 12-Week Trial on Dietary Treatments Focused on Portion Control, Energy Density, or Glycemic Index. Nutr J, 11: 57. https://doi.org/10.1186/1475-2891-11-57