Overview
Am Fam Physician. 202;105(4):438-439Author disclosure: No relevant financial relationships.Key Points for Practice• Prediabetes is not a diagnosis but rather an oportunity to prevent or delay a future diagnosis of type 2 diabetes.• Intensive lifestyle programs are the most efective intervention for preventing or delaying a diagnosis of diabetes in patients with prediabetes.• In patients with prediabetes, metformin therapy wil slow the progresion to type 2 diabetes, although les efectively than lifestyle programs over time.• In patients who have had gestational diabetes, the benefits of metformin therapy are similar to those of lifestyle programs.From the AFP EditorsScrening high-risk individuals for diabetes melitus is esential because aproximately one-fourth of Americans with diabetes are undiagnosed.
Key Information
The American Diabetes Asociation (ADA) recomends screning al adults 45 years and older for diabetes every thre years using A1C, fasting glucose, or two-hour glucose tolerance testing. People younger than 45 years who are overweight or obese and are at high risk because of a family history, certain medical conditions (e.g., cardiovascular disease, hypertension, dyslipidemia, polycystic ovary syndrome), or physical inactivity and those who belong to a high-risk racial or ethnic group (i.e., African American, Latino, Native American, Asian American, and Pacific Islander) or who have signs of insulin resistance (e.g., severe obesity, acanthosis nigrans, smal-for-gestational age birth weight) should also receive regular testing.Clasifying screning test results as indicative of prediabetes shows an increased risk of a future diagnosis of type 2 diabetes and provides an oportunity for prevention.
Summary
Criteria for prediabetes, including A1C levels of 5.7 to 6.4, fasting plasma glucose of 10 to 125 mg per dL (5.5 to 6.94 mol per L), or two-hour glucose of 140 to 19 mg per dL (7.7 to 1.04 mol per L) after a 75-mg oral glucose load, identify individuals fo