Prediabetes is a condition characterized by impaired fasting glucose, impaired glucose tolerance, or a combination of both, which is classified under the category of "Pi Dan" in Traditional Chinese Medicine (TCM). With the changes in modern lifestyles, the prevalence of prediabetes is continuously rising, carrying a risk comparable to diabetes prognosis. Therefore, timely diagnosis and early intervention are crucial. This article reviewed the origins and definitions of prediabetes from both TCM and modern medical perspectives, revealing that TCM had already recognized "Pi Dan" as early as the composition of the "SuWen". With the development of evidence-based medicine and the implementation of standardized clinical research, China has gradually established the standardized clinical practice guidelines for prediabetes with TCM characteristics. Regarding diagnosis, diagnostic indicators and thresholds for monitoring blood glucose levels, various non-invasive integrated TCM and modern medical diagnostic methods, including TCM syndrome diagnosis, integrated TCM and Western medicine diagnostic models, disease risk scoring models, biomarkers, and wearable devices, have been continuously improved. However, its primary focus lies in diabetes prevention rather than the early detection and screening of prediabetes. Besides, 1-hour plasma glucose may be a new outcome for prediabetes diagnosis or identifying high-risk diabetes populations in the future. However, further research is required to validate its broader application. Addressing the challenges of dynamic diagnostic standards, complex screening processes, atypical clinical symptoms, and low disease awareness during early prediabetes diagnosis, it is imperative to continuously update and refine diagnostic standards. The integration of digital health management and wearable devices should be promoted to fully capitalize on TCM strengths in constructingt disease diagnostic models that combine TCM macro manifestations and omics microdata for prediabetes. Simplified and expedited integrated TCM and modern medical screening methods can facilitate early screening, early diagnosis, early intervention, and early recovery for prediabetes.

糖尿病前期是一种表现为空腹血糖受损、糖耐量异常或两者的混合状态的疾病，属于中医"脾瘅"范畴。随着现代生活模式的改变，糖尿病前期的患病率不断升高，具有和糖尿病相当的预后风险，及时诊断并早期干预至关重要。本文从中医学和现代医学两个角度梳理了糖尿病前期的起源与定义，发现早在《素问》成书时，中医学便已对"脾瘅"形成了一定的认识。随着循证医学的发展和规范化临床研究的实施，我国逐步构建了具有中医特色的规范化糖尿病前期临床实践指南。在诊断方面，血糖检测指标类型和阈值、中医证候诊断、中西医结合诊断模型、疾病风险评分模型、生物标志物、可穿戴设备等多种无创中西医结合诊断方法不断完善，但多针对糖尿病患者的预防而非糖尿病前期的早期诊断和筛查；餐后1 h血糖可能是未来诊断糖尿病前期或糖尿病高危人群的新指标，但需进一步研究证实以推广使用。针对糖尿病前期中西医结合早期诊断面临的诊断标准的动态性、筛查流程的复杂性、临床症状的不典型性、疾病的低知晓性等挑战，未来需不断更新和完善诊断标准，融合数字化健康管理和可穿戴设备，充分发挥中医优势，构建针对糖尿病前期人群的基于中医宏观表征与组学微观数据相结合的疾病诊断模型，开发更简便、快捷的中西医结合筛查方法，实现糖尿病前期的"早筛查、早诊断、早干预、早康复"。