Prevention and Treatment of Type 2 Diabetes: A Pathophysiological-Based Approach

Prediabetes affects approximately 40% of American adults. Randomized trials report that a proportion of individuals with prediabetes develop diabetes despite caloric restriction, physical activity, and/or when treated with metformin, the first-line medication for patients with type 2 diabetes mellitus (T2DM). Currently, there are no valid predictors of the effectiveness of these measures in determining who will and who will not progress to the T2DM state. Few studies have examined the clinical and phenotypic predictors of better and worse glycemic response to lifestyle interventions and metformin in prediabetes and diabetes. Further studies incorporating 'omic' approaches to discover novel markers of phenotypes and treatment effectiveness may pave the way to personalizing the treatment of prediabetes and diabetes.