Pre-diabetes

Question 1

What is the HbA1c range for prediabetes?

Answer 1

HbA1c between 42-47 mmol or HbA1c 6% or fasting glucose 6.1-6.9

This range indicates an increased risk of developing type 2 diabetes.

Question 2

What is one recommended management strategy for prediabetes?

Answer 2

Lifestyle modification: weight loss, increased exercise, change in diet

These changes can help prevent the progression to type 2 diabetes.

Question 3

How often should follow-up blood tests be conducted for prediabetes management?

Answer 3

At least yearly

Regular monitoring helps track glucose levels and the risk of progression.

Question 4

What medication does NICE recommend for high-risk adults with prediabetes?

Answer 4

Metformin

This is recommended for those whose blood glucose measures indicate progression towards type 2 diabetes despite lifestyle changes.

Question 5

What does the term ‘pediabetes’ refer to?

Answer 5

Patients with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)

This term encompasses individuals at risk of developing type 2 diabetes.

Question 6

What percentage of adults in the UK are estimated to have prediabetes?

Answer 6

Around 1 in 7 adults

This signifies a significant public health concern regarding diabetes risk.

Question 7

What are the two main types of impaired glucose regulation (IGR)?

Answer 7

• Impaired fasting glucose (IFG)
• Impaired glucose tolerance (IGT)

Each type has different underlying mechanisms and risks associated with them.

Question 8

What is impaired fasting glucose (IFG) primarily caused by?

Answer 8

Hepatic insulin resistance

This condition indicates a problem with the liver’s response to insulin.

Question 9

What is impaired glucose tolerance (IGT) primarily caused by?

Answer 9

Muscle insulin resistance

This condition indicates that muscle cells are not responding effectively to insulin.

Question 10

Which group of patients is more likely to develop type 2 diabetes and cardiovascular disease?

Answer 10

Patients with IGT

This highlights the increased risk associated with IGT compared to IFG.

Question 11

What fasting glucose level indicates impaired fasting glucose (IFG)?

Answer 11

Greater than or equal to 6.1 but less than 7.0 mmol/l

This range identifies individuals at risk for diabetes.

Question 12

What defines impaired glucose tolerance (IGT)?

Answer 12

Fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

This diagnostic criteria helps categorize glucose tolerance levels.

Question 13

What test should people with IFG be offered to rule out diabetes?

Answer 13

Oral glucose tolerance test (OGTT)

This test assesses how the body processes glucose.

Question 14

What indicates that a person does not have diabetes but has IGT?

Answer 14

A result below 11.1 mmol/l but above 7.8 mmol/l

This result confirms the presence of IGT without indicating diabetes.

Question 15

What conditions can lead to falsely low HbA1c results?

Answer 15

• Sickle-cell anaemia
• GP6D deficiency
• Hereditary spherocytosis
• Haemodialysis

These conditions affect red blood cell lifespan and can skew HbA1c levels.

Question 16

What conditions can lead to falsely high HbA1c results?

Answer 16

• Increased red blood cell lifespan
• B12/folate deficiency
• Splenectomy
• Iron deficiency anaemia

These factors can also distort true glucose control assessments.