Issue 138 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