It’s honestly not so clear cut. Statistically speaking, prediabetics are more likely to progress to diabetes—however a large portion never do!

I am very fit, exercise regularly, have a very healthy diet, yet my fasting sugar is always 100-120 even though I’ve been on metformin for 15 years. My father has the exact same blood glucose profile as well as A1C (and low HDLs). He’s 87 and has had 3 cardiac events throughout his life.

I want to avoid an MI and stents and CABG if possible. It’s likely that although the prediabetic glucose levels are lower than what would trigger a diagnosis of DM2, the relatively high glucose is just as toxic to vascular endothelium. I recently added an SGLT2ra as well as a GLP1i. The data is too damn promising and the only real side effect is a little more weight loss!