Managing Prediabetes

Recommended by Catherine Coleman ProCOR
Physician's First Watch: "Consensus Statement Issued for Managing Prediabetes
The American College of Endocrinology has issued its first guidelines for management of patients with prediabetes.
Among the recommendations:
Patients with prediabetes (fasting glucose: 100–125 mg/dL; or 2-hour post-glucose challenge: 140–199 mg/dL) should undergo annual glucose tolerance and microalbuminuria testing.

Fasting plasma glucose, hemoglobin A1c, and lipids should be checked every 6 months.

As first-line treatment, patients should reduce their weight by 5%–10%, exercise for 30 to 60 minutes 5 days a week, and follow a low-fat, high-fiber diet.

For high-risk patients (e.g., those with worsening glycemia or cardiovascular disease), metformin and acarbose may be considered.

Lipid targets are the same as for patients with diabetes (e.g., LDL: 100 mg/dL); statins are recommended.

Blood pressure targets are also the same as for diabetic patients (systolic BP: <130 mm Hg; diastolic: 80 mm Hg), and ACE inhibitors and angiotensin receptor blockers should be considered first-line agents.

LINK(S):
Prediabetes consensus statement (Free PDF)
Published in Physician's First Watch July 24, 2008"