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Pre-diabetes is a reversible metabolic state where blood glucose is elevated above normal but below the diagnostic threshold for Type 2 Diabetes Mellitus (T2DM).
Affects ~98 million U.S. adults
5–10% per year progress to T2DM if untreated
↑ Risk of cardiovascular disease (CVD) and microvascular complications
Early detection allows up to 58% reduction in T2DM progression with lifestyle changes.
Pre-diabetes is diagnosed when blood glucose or HbA1c levels are above normal but below diabetes thresholds. It signals impaired glucose regulation and carries a high risk of progression to Type 2 Diabetes Mellitus (T2DM).
Diagnosis is based on lab criteria: HbA1c, fasting plasma glucose (FPG), or oral glucose tolerance test (OGTT).
Thresholds differ slightly between US (ADA) and UK/WHO guidelines.
Diagnosis can be made with any one abnormal result, but repeat testing is advised if asymptomatic.
Screening is recommended for at-risk individuals (e.g. age ≥45, BMI ≥25, FHx of diabetes, hypertension, PCOS).
| Test | ADA / US | UK / WHO / NICE |
|---|---|---|
| HbA1c (↑) | 5.7–6.4% (NGSP) ↔ 39–47 mmol/mol (IFCC) | 6.0–6.4% (NGSP) ↔ 42–47 mmol/mol (IFCC) |
| Fasting Plasma Glucose (↑) | 100–125 mg/dL ↔ 5.6–6.9 mmol/L | 110–125 mg/dL ↔ 6.1–6.9 mmol/L... |
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