Type 2 diabetes mellitus (T2DM) is a serious health problem with epidemic proportions and associated with high cardiovascular morbidity and mortality. Thus, the prevention or at least delaying the onset of T2DM is imperative. Subjects with impaired glucose metabolism (prediabetes) are highly likely to develop overt T2DM. Treatment of accompanied cardiovascular risk factors, such as hypertension and dyslipidemia, in these patients is frequently complicated as it can impair the already altered glucose homeostasis. This review discusses the pathophysiology of lipid disorders and hypertension in prediabetes along with the effects of lipid modifying and antihypertensive drugs in glucose/insulin metabolism. A critical overview and suggestions of different treatment options for prediabetic patients with dyslipidemia and/or hypertension are also presented.