The availability of interventions that have been shown to decrease the development of diabetes has stimulated consideration whether such interventions should be recommended and implemented, in whom, and under what circumstances. To address these issues, the American Diabetes Association convened a consensus development conference on 16–18 October 2006 focusing on the pre-diabetic states of IFG and IGT. Following the presentations of invited speakers and in-depth discussions, a seven-member panel of experts in diabetes, endocrinology, and metabolism developed this consensus position based on the questions below. The expert members were also asked to note where additional information or studies would be necessary to answer these questions.