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 .
The Comparative Effectiveness of Diabetes Prevention Strategies to Reduce Postpartum Weight Retention in Women With Gestational Diabetes Mellitus: The Gestational Diabetes’ Effects on Moms (GEM) Cluster Randomized Controlled Trial
OBJECTIVE To compare the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestational diabetes mellitus ( GDM ) delivered at the health system level : mailed recommendations ( usual care ) versus usual care plus a Diabetes Prevention Program (DPP)–derived lifestyle intervention . RESEARCH DESIGN AND METHODS This study was a cluster r and omized controlled trial of 44 medical facilities ( including 2,280 women with GDM ) r and omized to intervention or usual care . The intervention included mailed gestational weight gain recommendations plus 13 telephone sessions between 6 weeks and 6 months postpartum . Primary outcomes included the following : proportion meeting the postpartum goals of 1 ) reaching pregravid weight if pregravid BMI < 25.0 kg/m2 or 2 ) losing 5 % of pregravid weight if BMI ≥25.0 kg/m2 ; and pregravid to postpartum weight change . RESULTS On average , over the 12-month postpartum period , women in the intervention had significantly higher odds of meeting weight goals than women in usual care ( odds ratio [ OR ] 1.28 [ 95 % CI 1.10 , 1.47 ] ) . The proportion meeting weight goals was significantly higher in the intervention than usual care at 6 weeks ( 25.5 vs. 22.4 % ; OR 1.17 [ 1.01 , 1.36 ] ) and 6 months ( 30.6 vs. 23.9 % ; OR 1.45 [ 1.14 , 1.83 ] ) . Condition differences were reduced at 12 months ( 33.0 vs. 28.0 % ; OR 1.25 [ 0.96 , 1.62 ] ) . At 6 months , women in the intervention retained significantly less weight than women in usual care ( mean 0.39 kg [ SD 5.5 ] vs. 0.95 kg [ 5.5 ] ; mean condition difference −0.64 kg [ 95 % CI −1.13 , −0.14 ] ) and had greater increases in vigorous-intensity physical activity ( mean condition difference 15.4 min/week [ 4.9 , 25.8 ] ) . CONCLUSIONS A DPP-derived lifestyle intervention modestly reduced postpartum weight retention and increased vigorous-intensity physical activity
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 .