Individuals with prediabetes (HbA1c between 5.7%-6.4%) appear to have similar cardiovascular risk factors as patients with diabetes. In a study, about 36% of patients with impaired fasting glucose had coronary artery disease compared with 42% of patients with diabetes and 21% of patients with normal blood glucose said Harith Al-Shuwaykh, MD, a resident in internal medicine at Crittenton Hospital Medical Center, Wayne State University, Detroit. These findings, which were based on a review of 86 patients who underwent elective percutaneous coronary intervention, were presented at the annual meeting of the American Association of Clinical Endocrinologists.

Likewise 37% of patients with impaired fasting glucose had hyperlipidemia compared with 38% of patients with diabetes and 24% of patients with normal blood glucose.The results indicate that early intervention among the prediabetics may be warranted. 9 of the individuals had normal fasting glucose levels, that is fasting blood glucose below 100 mg/dL; 30 patients had impaired fasting blood glucose levels (100-125 mg/dL) and 37 patients were diabetic with fasting blood glucose levels above 125 mg/Dl.

Studies like this impact pharmacologic intervention with impaired fasting glucose," Dolinar said. "Historically we have told our patients to diet and exercise and that is a good idea, but it just doesn't work. Fortunately we have pharmaceutical interventions so that when we have patients with Type 2 diabetes we can intervene with a variety of medications.

"I think that in the case of prediabetes we should consider intervening pharmacologically because there are abnormalities there that we could treat. It would be off label but I think it would be important to look at that and get more studies and study this further," he said. Al-Shuwaykh said there were limitations to his study, particularly the retrospective design and the lack of a control group.