ABSTRACT
Benefits of early diagnosis and treatment of diabetes: clinical perspective
Early detection and timely initiation of treatment of diabetes are crucial for improving patient outcomes. This review summarizes the existing evidence for the benefits of a prompt diagnosis and induction of medical interventions in various types of diabetes. We examined recent clinical trials and studies relating to type 2 diabetes, prediabetes, type 1 diabetes, secondary (type 3) diabetes and gestational diabetes, emphasizing outcomes associated with early detection and provision of intensive therapy. Early diagnosis of type 2 diabetes and initiation of immediate intensive glycemic control produce a ‘metabolic memory’ effect associated with a long-term reduction of microvascular complications and cardiovascular risk.As soon as prediabetes is identified, it is possible to commence certain interventions (lifestyle changes or medications) that can reduce progression to diabetes by about 30-60%. New therapies, including GLP-1 receptor agonists and dual GIP/GLP-1 agonist tirzepatide, can markedly enhance glycemic control, induce substantial weight loss, improve beta-cell function, and have the potential to induce diabetes remission or prevent disease onset in high-risk individuals. Screening for islet autoantibodies in type 1 diabetes enables establishing an earlier diagnosis, thus drastically reducing the rate of ketoacidosis at onset, and immunomodulatory therapy (e.g. anti-CD3 antibodies) has shown promise in delaying clinical disease. Prompt recognition of secondary (type 3) diabetes (e.g. pancreatogenic) is important for treating underlying causes (such as pancreatic disorders) and can facilitate earlier detection of pancreatic cancer. Early diagnosis and proper management of gestational diabetes significantly reduce perinatal complications (e.g. macrosomia, birth trauma, preeclampsia) as well as long-term metabolic risks for the mother and the child. Conclusions: Early detection and timely initiation of appropriate treatment of diabetes help provide significant benefits, including complication risk reduction, potential disease remission, and improved survival.
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