Prediabetes should be viewed as an active cardiometabolic disease stage rather than a passive risk marker. Cardiovascular injury begins before overt diabetes, creating a critical window for intervention. Lifestyle therapy remains fundamental, while agents such as metformin, GLP-1 receptor agonists, dual incretin therapies, and SGLT2 inhibitors may help modify long-term cardiovascular risk.

https://www.scvc.co.uk/vat/glucose-insulin-dynamics/prediabetes-as-a-therapeutic-target-a-cardiologists-editorial-perspective/