UBC Faculty Research and Publications

What to do about borderline hyperglycemia? University of British Columbia. Therapeutics Initiative


Background: Therapeutics Letter 140 discusses the issue of borderline hyperglycemia, a condition where blood sugar levels are slightly elevated but not high enough to be diagnosed as diabetes. This condition is becoming increasingly common and is associated with a higher risk of developing diabetes, cardiovascular disease, and other health problems. Methods: Current research on the management of borderline hyperglycemia was reviewed, including lifestyle interventions such as diet and exercise, as well as pharmacological interventions. The limitations of current diagnostic criteria for diabetes and the need for more accurate methods of identifying individuals at risk for the disease were also discussed. Results: The authors concluded that lifestyle interventions are the first-line treatment for individuals with borderline hyperglycemia, and that pharmacological interventions should be reserved for those who are at higher risk of developing diabetes or who have other risk factors. Available evidence suggests large RCTs combining lifestyle interventions with newer drugs such as GLP-1 agonists and SGLT2 inhibitors could potentially identify more promising treatments. Conclusions: Many people with borderline hyperglycemia will not progress to type 2 diabetes. Borderline hyperglycemia is associated with adverse health outcomes, but other risk factors for cardiovascular disease may be more important. Borderline hyperglycemia can be used as a “wake up call”: an opportunity to discuss options. Emphasize lifestyle optimization with improved diet and physical activity.

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