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Type 2 diabetes mellitus (T2DM) is the most frequent metabolic disease and is a major risk factor for cardiovascular diseases and mortality. About 9% of the worldwide population, around 347 million people, is expected to present this condition with 50% to 80% of them having a future fatal cardiovascular complication like myocardial infarction, stroke, or heart failure.1 Even more concerning, estimations from the National Health and Nutrition Examination Survey demonstrated that ≤35.3% of the adult US population has prediabetes.2 This is 4 times the number of subjects currently having already a diagnosis of T2DM.2 However, not much is known about the preclinical cardiovascular changes, such as alterations of left ventricular (LV) structure and function, associated with dysglycemic conditions before the diagnosis of T2DM.See Article by Demmer et al  study by Demmer et al3 in this issue of Circulation: Cardiovascular Imaging investigated the associations of 3 primary exposures (glycemic status, diabetes mellitus control, and insulin resistance as assessed by homeostasis model assessment-estimated insulin resistance quintiles) with cardiac structure and function by modern echocardiographic techniques. Although the diabetes mellitus status was based on American Diabetes Association criteria, the definitions were a little mixed with the use of glycohemoglobin (HbA1c), fasting plasma glucose, and 2-hour postload plasma glucose. The agreement among fasting plasma glucose, 2-hour postload plasma glucose, and HbA1c for the definition of groups of nondiabetic, prediabetic, and diabetic is not perfect, and individuals included in each group are expected to be different depending on the test used.4 Accordingly, a more preferable approach would be the use of just one definition. The study sample consisted of 1818 individuals (57% women) aged u003e45 years (average age: 56 years) with Hispanic/Latino ethnicity (predominant self-identifying …

Relation of Early and Late Stages of Glucose Metabolism Disturbances With Left Ventricular Geometry and Function