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Recognizing dysglycemia as a disease continuum rather than a transitional condition supports the need for anticipatory and integrated preventive strategies. Within this framework, nutraceuticals are emerging as valuable supportive tools in the management of dysglycemia, particularly in individuals with increased metabolic risk who are not yet candidates for pharmacological therapy. Nutraceutical compounds can target key pathophysiological mechanisms underlying dysglycemia, including impaired insulin sensitivity, oxidative stress, chronic low-grade inflammation, and altered postprandial glucose metabolism. Clinical evidence supports the use of selected micronutrients, polyphenols, and standardized plant extracts in improving fasting and postprandial glycemic control. Phytocomplexes derived from plants such as Mangifera indica, Momordica charantia, and Malus domestica exert complementary and multitarget actions, including modulation of carbohydrate absorption, activation of AMPK-related pathways, enhancement of peripheral glucose uptake, stimulation of incretin secretion, and improvement of endothelial function. When integrated with lifestyle and dietary interventions, nutraceuticals may reduce glycemic variability, improve metabolic resilience, and delay progression toward type 2 diabetes. Overall, nutraceuticals represent a rational bridge between lifestyle measures and pharmacological treatment in the personalized management of dysglycemia.<\/jats:p>","DOI":"10.3390\/nu18050868","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:49:42Z","timestamp":1773071382000},"page":"868","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dysglycemia and Cardiometabolic Risk: Pathophysiological Rationale and the Emerging Role of Nutraceuticals in Integrated Prevention"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-3884","authenticated-orcid":false,"given":"Arrigo Francesco Giuseppe","family":"Cicero","sequence":"first","affiliation":[{"name":"Cardiovascular Medicine Unit, Heart, Chest and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum-University of Bologna, Sant\u2019Orsola-Malpighi Hospital, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1592-5586","authenticated-orcid":false,"given":"Giovanni","family":"Scapagnini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1005-4689","authenticated-orcid":false,"given":"Davide","family":"Grassi","sequence":"additional","affiliation":[{"name":"Department MeSVA\u2013UOC Internal Medicine-Center of Obesity, Nutrition and Cardio-Nephro-Metabolic Prevention, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2852-5610","authenticated-orcid":false,"given":"Giuseppe","family":"Marazzi","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele, 00163 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Zanch\u00e8","sequence":"additional","affiliation":[{"name":"Pescara Local Health Authority (ASL), 65100 Pescara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-5840","authenticated-orcid":false,"given":"Alessandro D.","family":"Genazzani","sequence":"additional","affiliation":[{"name":"Center for Endocrinological Gynecology, Department of Maternal, Infant and Adult Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7353-8437","authenticated-orcid":false,"given":"Roberta","family":"Scairati","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Section of Endocrinology, Diabetology, Andrology and Nutrition, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Section of Endocrinology, Diabetology, Andrology and Nutrition, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"m2297","DOI":"10.1136\/bmj.m2297","article-title":"Association between Prediabetes and Risk of All Cause Mortality and Cardiovascular Disease: Updated Meta-Analysis","volume":"370","author":"Cai","year":"2020","journal-title":"BMJ"},{"key":"ref_2","first-page":"e49602","article-title":"Prevalence of Retinopathy in Prediabetic Populations: A Systematic Review and Meta-Analysis","volume":"15","author":"Sune","year":"2023","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e040997","DOI":"10.1136\/bmjopen-2020-040997","article-title":"Prevalence of Retinopathy in Prediabetes: Protocol for a Systematic Review and Meta-Analysis","volume":"11","author":"Kirthi","year":"2021","journal-title":"BMJ Open"},{"key":"ref_4","first-page":"e56674","article-title":"Understanding the Clinical Relationship Between Diabetic Retinopathy, Nephropathy, and Neuropathy: A Comprehensive Review","volume":"16","author":"Kulkarni","year":"2024","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.avsg.2024.06.045","article-title":"Prediabetes and the Risk of Peripheral Artery Disease: A Meta-Analysis","volume":"110","author":"Zhang","year":"2025","journal-title":"Ann. 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