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Item
#3
Criteria
for Diagnosing Pre-Diabetes
BMI,
A1c, fasting and postprandial readings can diagnose Pre-Diabetes
Measuring
body mass index and setting cutoff
values for fasting glucose levels and
A1Cs may be enough to determine whether
an individual has pre-diabetes without having to administer
an oral glucose tolerance
test (OGTT), say researchers
in Maryland-including one at the National Institute for
Diabetes and Digestive and
Kidney Diseases.
In
the Diabetes Prevention Program, criteria
for intervention include a body mass
index (BMI) of 24 percent or greater, a fasting plasma glucose
level of
96 to 125 mg/dl and a two-hour glucose
level of 140 to 199 mg/dl measured
by an OGTT. Unlike the other measures,
the OGTT is considered to be
a time-consuming, inconvenient and
expensive procedure. After
analyzing data from a sample of U.S. adults ages 40 to 74,
researchers determined that
using a BMI of 24 percent
or more as an initial criterion eliminated 27.2 percent from
needing an OGTT. Of the
remaining subjects, 41.1
percent did not need an OGTT because their fasting glucose levels varied
from the established values of 96
to 125 mg/dl. An A1C
level greater than 5.5%
also was established as a cutoff value.
Individuals
with pre-diabetes are urged to use lifestyle changes, including
diet and exercise, to prevent progression
to clinical diabetes. Diabetes
Care, November
2002
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