Role of newer anti-diabetes drugs in prediabetes: A systematic review

Prediabetes is a metabolic condition characterized by either impaired fasting plasma glucose (IFG) or impaired glucose tolerance (IGT) or both, having glucose values above the upper threshold of normal but below the threshold for diabetes diagnosis. Prediabetes (IFG or IGT or both) is not only associated with an increased risk of overt diabetes progression but has been linked to a heightened risk of both micro- and macro-vascular complications. Newer anti-diabetes drugs that have been studied in prediabetes have shown mixed results. While DPP-4 inhibitors could not show any significant effect, GLP-1 receptor agonists have a favorable effect on the progression to overt type 2 diabetes during active treatment in people with prediabetes. SGLT-2 inhibitors have shown favorable effects in prediabetes on both progressions as well as in reducing cardio-renal complications, especially in people with established heart failure or chronic kidney disease during the active treatment period. Nevertheless, it is not yet clearly known whether favorable outcomes observed during the active treatment phase in people with prediabetes would be extended after the wash-out period. More studies are clearly needed.