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 .
Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study
Objective To assess effectiveness and implementability of the public health programme Life ! Taking action on diabetes in Australian people at risk of developing type 2 diabetes . Research design and methods Melbourne Diabetes Prevention Study ( MDPS ) was a unique study assessing effectiveness of Life ! that used a r and omized controlled trial design . Intervention participants with AUSDRISK score ≥15 received 1 individual and 5 structured 90 min group sessions . Controls received usual care . Outcome measures were obtained for all participants at baseline and 12 months and , additionally , for intervention participants at 3 months . Per protocol set ( PPS ) and intention to treat ( ITT ) analyses were performed . Results PPS analyses were considered more informative from our study . In PPS analyses , intervention participants significantly improved in weight ( −1.13 kg , p=0.016 ) , waist circumference ( −1.35 cm , p=0.044 ) , systolic ( −5.2 mm Hg , p=0.028 ) and diastolic blood pressure ( −3.2 mm Hg , p=0.030 ) compared with controls . Based on observed weight change , estimated risk of developing diabetes reduced by 9.6 % in the intervention and increased by 3.3 % in control participants . Absolute 5-year cardiovascular disease ( CVD ) risk reduced significantly for intervention participants by 0.97 percentage points from 9.35 % ( 10.4 % relative risk reduction ) . In control participants , the risk increased by 0.11 percentage points ( 1.3 % relative risk increase ) . The net effect for the change in CVD risk was −1.08 percentage points of absolute risk ( p=0.013 ) . Conclusions MDPS effectively reduced the risk of diabetes and CVD , but the intervention effect on weight and waist reduction was modest due to the challenges in recruiting high-risk individuals and the abbreviated intervention
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 .