Abstract / Summary
The prevalences of overweight, obesity, prediabetes, and diabetes are rapidly increasing worldwide, accompanied by increased insulin resistance (IR). Although the proportions of these populations vary greatly by region, a common trend across all areas is the increasing the prevalence of overweight, obesity, impaired glucose tolerance (IGT)/prediabetes and diabetes throughout all income levels. Based on the international baseline standards provided by the World Health Organization, national health and hygiene agencies and local expert organizations are implementing more proactive screening protocols tailored to local circumstances. These indicators are based on anthropometric measurements and do not include measurements of blood or urine biomarkers. However, evidence-based screening methods utilizing measurements of blood biomarkers, such as blood glucose levels and hemoglobin A1c, generally target individuals aged 40 and older. Therefore, screening based on anthropometric indices, adjusted for regional and racial characteristics and targeting individuals under 40 years old, can fail to identify individuals at relatively high risk for metabolic disorders, such as IGT or prediabetes, even when their measurements fall within the reference range. There are important points to consider regarding the measurement and interpretation of biomarkers used for diabetes screening. This review outlines the limitations and key considerations associated with biomarker measurement for screening IGT/prediabetes, diabetes, and elevated IR.