Conclusions HbA1c is neither sensitive nor specific for detecting pre‐diabetes ; fasting glucose is specific but not sensitive .
Interventions in people classified through screening as having pre‐diabetes have some efficacy in preventing or delaying onset of type 2 diabetes in trial population s. As screening is inaccurate , many people will receives an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the intervention .
These findings suggest that “ screen and treat ” policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes .
& NA ; Objectives To assess diagnostic accuracy of screening tests for  pre‐diabetes  and efficacy of interventions ( lifestyle or metformin ) in preventing onset of type 2 diabetes in people with pre‐diabetes .
Diabetes mellitus and abnormal glucose tolerance development after gestational diabetes: A three-year, prospective, randomized, clinical-based, Mediterranean lifestyle interventional study with parallel groups.
BACKGROUND & AIMS Women with prior gestational diabetes mellitus ( GDM ) have a high risk of developing type 2 diabetes mellitus ( DM2 ) in later life . The study aim was to evaluate the efficacy of a lifestyle intervention for the prevention of glucose disorders ( impaired fasting glucose , impaired glucose tolerance or DM2 ) in women with prior GDM . METHODS A total of 260 women with prior GDM who presented with normal fasting plasma glucose at six to twelve weeks postpartum were r and omized into two groups : a Mediterranean lifestyle intervention group ( n = 130 ) who underwent an educational program on nutrition and a monitored physical activity program and a control group ( n = 130 ) with a conventional follow-up . A total of 237 women completed the three-year follow-up ( 126 in the intervention group and 111 in the control group ) . Their glucose disorders rates , clinical and metabolic changes and rates of adherence to the Mediterranean lifestyle were analyzed . RESULTS Less women in the intervention group ( 42.8 % ) developed glucose disorders at the end of the three-year follow-up period compared with the control group ( 56.75 % ) , p < 0.05 . The multivariate analysis indicated a reduction in the rate of glucose disorders with a BMI of less than 27 kg/m(2 ) ( OR 0.28 ; 0.12 - 0.65 ; p < 0.003 ) , low fat intake pattern ( OR 0.30 ; 0.13 - 0.70 ; p < 0.005 ) , low saturated fat pattern ( OR 0.30 ; 0.13 - 0.69 ; p < 0.005 ) and healthy fat pattern ( OR 0.34 ; 0.12 - 0.94 ; p < 0.04 ) . CONCLUSIONS Lifestyle intervention was effective for the prevention of glucose disorders in women with prior GDM . Body weight gain and an unhealthy fat intake pattern were found to be the most predictive factors for the development of glucose disorders . Current Controlled trials : IS RCT N24165302 . http://www.controlled-trials.com/is rct n/pf/24165302
Conclusions HbA1c is neither sensitive nor specific for detecting pre‐diabetes ; fasting glucose is specific but not sensitive .
Interventions in people classified through screening as having pre‐diabetes have some efficacy in preventing or delaying onset of type 2 diabetes in trial population s. As screening is inaccurate , many people will receives an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the intervention .
These findings suggest that “ screen and treat ” policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes .
& NA ; Objectives To assess diagnostic accuracy of screening tests for  pre‐diabetes  and efficacy of interventions ( lifestyle or metformin ) in preventing onset of type 2 diabetes in people with pre‐diabetes .