Prevention of T2DM in prediabetes1

By makin, 7 October, 2014
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<sup>1</sup> IGT (impaired glucose tolerance) = 75-g-OGTT 2-h PG 140-199 mg/dL; IFG (impaired fasting glucose) = FPG 100-125 mg/dL. <br><br><sup>2</sup> &alpha;-Glucosidase inhibitors, orlistat, and TZDs have also been shown to decrease incident T2DM to various degrees.
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Refer pts w/ IGT, IFG,1 or A1C 5.7%-6.4% to intensive diet/physical activity behavioral counseling program targeting 7% body wt loss & increasing mod physical activity (eg, walking) to at least 150 min/wk [A]
Metformin2 to prevent T2DM has the strongest evidence and long-term safety profile: Consider if BMI >35 kg/m^2, age
Monitor at least annually [E], screen for & treat modifiable CV risks [B]
Diabetes self-mgmt/support programs & technology-assisted tools may help prevent/delay onset of T2DM [B]
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Prevention of T2DM in prediabetes<sup>1</sup>