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 .
Patient freedom to choose a weight loss diet in the treatment of overweight and obesity: a randomized dietary intervention in type 2 diabetes and pre-diabetes
Background Offering the overweight or obese patient the option of choosing from a selection of weight loss diets has not been investigated in type 2 diabetes . The aim of the study was to investigate if the option to choose from , and interchange between a selection of diets ( “ Choice ” ) , as opposed to being prescribed one set diet ( “ No Choice ” ) , improves drop out rates and leads to improved weight loss and cardio-metabolic outcomes . Methods The study was a 12 month , r and omized parallel intervention . A total of 144 volunteers with type 2 diabetes or pre-diabetes and a BMI > 27 were r and omized to “ No Choice ” or “ Choice ” . Those in the No Choice group were placed on a set weight loss diet ( CSIRO ) with no change permitted . Those in the Choice group could choose from , and interchange between , the CSIRO , South Beach or Mediterranean diets . Results There were no differences in attrition rates or weight loss between the “ Choice ” and “ No Choice ” . In a secondary analysis of the intention-to-treat weight loss data with last measured weight carried forward gave a highly significant diet group by time by gender interaction ( p = 0.002 ) with men doing better in the No Choice group overall ( maximum difference “ No Choice “ -2.9 ± 4.6 kg vs. “ Choice”-6.2 kg ± 5.3 kg at 6 months ) and women doing better in the Choice group overall ( maximum difference Choice -3.1 ± 3.7 kg vs. “ No Choice ” -2.0 kg ± 2.6 kg at 6 months ) . Conclusions Men prefer direction in their weight loss advice and do less well with choice . A gender-specific approach is recommended when prescribing weight loss diets . Trial registration anzctr.org.au ACTRN12612000310864
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 .