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 .
Breast-feeding is associated with reduced postpartum maternal glucose intolerance after gestational diabetes.
Gestational diabetes mellitus ( GDM ) is associated with adverse foetal and maternal outcomes , and identifies women at risk of future Type 2 Diabetes Mellitus ( T2DM ) . Breast-feeding may improve postpartum maternal glucose tolerance . We prospect ively examined the prevalence of postpartum dysglycaemia after GDM and examined the effect of lactation on postpartum glucose tolerance . We compared postpartum 75 g oral glucose tolerance test ( OGTT ) results from 300 women with GDM and 220 controls with normal gestational glucose tolerance ( NGT ) .  Breast-feeding data was collected at time of OGTT . Postpartum OGTT results were classified as normal [ fasting plasma glucose ( FPG ) < 5.6mmol/l , 2-h < 7.8 mmol/l ] and abnormal [ impaired fasting glucose ( IFG ) , FPG 5.6 - 6.9 mmol/l ; impaired glucose tolerance ( IGT ) , 2-h glucose 7.8 - 11 mmol/l ; IFG+IGT ; T2DM , FPG > or = 7 mmol/l + /- 2h glucose > or = 11.1 mmol/l ] . 6 ( 2.7 % ) with NGT in pregnancy had postpartum dysglycaemia compared to 57 ( 19 % ) with GDM in index pregnancy ( p < 0.001 ) . Non-European ethnicity ( OR 3.40 , 95 % CI 1.45 - 8.02 , p = 0.005 ) , family history of T2DM ( OR 2.14 , 95 % CI 1.06 - 4.32 , p = 0.034 ) and gestational insulin use ( OR 2.62 , 95 % CI 1.17 - 5.87 p = 0.019 ) were associated with persistent dysglycaemia . The prevalence of persistent hyperglycaemia was significantly lower in women who breast-fed versus bottle-fed postpartum ( 8.2 % v 18.4 % , p < 0.001 ) . Breast-feeding may confer beneficial metabolic effects after GDM and should be encouraged
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 .