PREDIABETES ADVERSE OUTCOME

IGT; in which 2h plasma glucose is more than 140 mg/dl and less than 200mg/dl (i.e 7.8 – 11 mmol/L) ,while IFG means that fasting blood sugar is more than 100mg/dl and less than 126mg/dl (i.e 5.5 -7 mmol/L).Screening programs for D.M. & prediabetes should include people with high risk for developing D.M. e.g aged >45 years.A developing literature links pre-diabetes to complications that traditionally are attributed to diabetes. These complications include both macrovascular (myocardial infarction and stroke), and microvascular disease as retinopathy, microalbuminuria, and polyneuropathy.The current therapeutic approaches to glycemic control have focused primarily on insulin resistance and deficient insulin secretion, whereas lifestyle changes have addressed reducing caloric intake and enhancing exercise activity. For persons with prediabetes at particularly high risk, pharmacologic glycemic treatment may be considered in addition to lifestyle changes. Metformin and acarbose are safe and effective in helping prevent diabetes. Although thiazolidinediones decrease the risk for progression from prediabetes to diabetes, safety concerns include congestive heart failure or fractures.