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Diabetes

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Prediabetes

Prediabetes, often referred to as impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), is characterized by glucose levels that are higher than normal but not high enough to be diagnostic of diabetes. Recent data from the Centers for Disease Control and Prevention suggest that an estimated 86 million adults in the U.S. had prediabetes in 2012. Usually those who have prediabetes do not have any symptoms but if nothing is done to lower their glucose levels, they are at an increased risk of developing diabetes within about 10 years.

The American Diabetes Association (ADA) and the United States Preventive Services Task Force recommend diabetes screening for adults age 45 and older and for adults who are under 45 years of age, overweight, and have any additional risk factors for type 2 diabetes.

Risk factors include:

  • Being overweight, obese, or physically inactive
  • Having a close (first degree) relative with diabetes
  • Being a woman who delivered a baby weighing more than 9 pounds or with a history of gestational diabetes
  • Being a woman with polycystic ovarian syndrome (PCOS)
  • Being of a high-risk race or ethnicity such as African American, Latino, Native American, Asian American, Pacific Islander
  • Having high blood pressure (hypertension) or taking medication for high blood pressure
  • Having a low HDL cholesterol level (less than 35 mg/dL or 0.90 mmol/L and/or a high triglyceride level (more than 250 mg/dL or 2.82 mmol/L)
  • Having an A1C equal to or above 5.7% or prediabetes identified by previous testing
  • Having a history of cardiovascular disease (CVD)

The ADA also recommends that children who are overweight and have two or more risk factors should be considered for diabetes screening. If prediabetes is detected, then yearly follow-up testing is recommended.

Signs and Symptoms

Those with prediabetes will not have any signs or symptoms at the time of diagnosis.

Laboratory Tests

Screening and diagnostic tests are the same as those used for type 2 diabetes (see the Tests section).

Monitoring is not generally indicated, but the ADA recommends that people with prediabetes be screened for the development of diabetes on a yearly basis.

Treatment

The primary focus of treatment for prediabetes and prevention of progression to type 2 diabetes is lifestyle changes. Weight loss, eating a healthy diet, and regular physical activity can help prevent or delay the development of type 2 diabetes and reduce blood glucose levels. In some cases, oral diabetes medications may also be prescribed.

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