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The underlying pathophysiology of type 2 diabetes [DM 2] is the progressive decline and in the end/eventually cessation of pancreatic function. This is due to the inability of pancreatic beta cells to produce insulin and maintain normal blood glucose levels.

It is important to know that the pathology of diabetes is a spectrum of glucose and insulin control levels: from impaired glucose tolerance and prediabetes to a diagnosis of diabetes.

It should be noted that defects in glucose metabolism often occur long before a disease is diagnosed. For example, people who have normal blood sugar but are insulin-resistant and progress to tolerated impaired glucose may have already lost half of their β-cell function, and people who already have a positive oral glucose tolerance test [OGTT] approximately 80% of β-cell function will be lost [1].

Thus, the term prediabetes includes dysglycemia, such as altered fasting blood glucose (110-125 mg/dl on an empty stomach in the morning), decreased glucose tolerance - OGTT at 2h 140-199 mg/dl or a glycated haemoglobin value between 5.7- 6.4%. At this stage, diabetes can be prevented if we diagnose it in its early stages and take the necessary weight loss measures.

Progressive impairment of glucose tolerance and β-cell function indicates that time is a crucial factor in diabetes prevention, and large-scale diabetes prevention programs have focused on pre-diabetes intervention [2-4].

A review of 9 interventional studies found that the main factor in preventing the progression from prediabetes to DM 2 was weight loss, achieved both by achieving dietary goals and by physical activity. For example, the DPP (Diabetes Prevention Program) study found that a weight loss of about 5 kg was the strongest factor associated with a 55% decrease in the risk of diabetes at 3 years, regardless of exercise. physical or diet. In other words, a 5-7% weight loss of the current weight can halve the risk of developing DZ2.

On the other hand, although interventions are currently effective, achieving long-term adherence remains a challenge, but the data suggest that maintaining a weight loss of at least 5% is necessary to prevent progression to DM 2 [5 - 7].

In Romania, the factors that predispose us to an increased risk of prediabetes are overweight or obesity, age over 45 years, a first degree relative with diabetes, physical activity less than 3 times a week and gestational diabetes.

Given that 1 in 3 people have prediabetes and 9 in 10 are unaware of this, screening for risk factors and glycemic/glycated haemoglobin is the first step in detecting prediabetes.

Diabetes can be prevented if it is diagnosed and treated in the early stages, ie prediabetes. Don't wait until you are diagnosed with diabetes to take the necessary steps for your health.