Microvascular complications in prediabetes: a systematic review & meta-analysis
Authors' conclusion
Prediabetes ADA criteria (HbA1c 5.7-6.4 %) identified significantly more retinopathy than IEC criteria (HbA1c 6.0-6.4 %), suggesting that ADA criteria are preferable for early retinopathy detection and clinical retinal screening may be considered at HbA1c ≥ 5.7 %. Insufficient studies on the prevalence of nephropathy and neuropathy in prediabetes were available.
Study context
- Population
- Prediabetes studies reporting retinopathy, nephropathy and/or neuropathy; Embase, MEDLINE, Scopus, Cochrane, CINAHL, 1990–May 202335 studies analysed
- Comparison
- American Diabetes Association (ADA) prediabetes criteria vs International Experts Committee (IEC) criteria
- Outcome
- Microvascular complications (retinopathy, nephropathy, neuropathy) above a prediabetic HbA1c or FBG cut-off
Pooled result
As reported in the abstract
Retinopathy prevalence and incidence
ADA vs IECWeighted Mean Difference (CI)
Prevalence; significantly higher with ADA
2.37(2.31,2.43)
Incidence; significantly higher with ADA
1.32(1.25,1.40)
Further pooled results
Diagnostic performance for retinopathy (ROC)
Sensitivity
Specificity
AUC ADA 0.73 · IEC 0.88
- Diagnostic performance for retinopathy (ROC): ADA criteria at 5.9%
Nephropathy prevalence (hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) criteria)
- Nephropathy prevalence
- 1.0%-15.0%
- No studies reported nephropathy/neuropathy by IEC criteria
Original publication
Microvascular complications in prediabetes: a systematic review & meta-analysis. Diabetes Res Clin Pract. Published 24 May 2025. doi:10.
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