Recommendations
c Patients with impaired glucose tolerance (IGT) A, impaired fasting glucose
(IFG) E, or an A1C 5.7–6.4% E should be referred to an intensive diet and
physical activity behavioral counseling program targeting loss of 7% of body
weight and increasing moderate-intensity physical activity (such as brisk walking)
to at least 150 min/week.
c Follow-up counseling may be important for success. B
c Based on the cost-effectiveness of diabetes prevention, such programs should
be covered by third-party payers. B
c Metformin therapy for prevention of type 2 diabetes may be considered in
those with IGT A, IFG E, or an A1C 5.7–6.4% E, especially for those with BMI
.35 kg/m2
, aged ,60 years, and women with prior gestational diabetes
mellitus (GDM). A
c At least annual monitoring for the development of diabetes in those with
prediabetes is suggested. E
c Screening for and treatment of modifiable risk factors for cardiovascular disease
is suggested. B
c Diabetes self-management education (DSME) and support (DSMS) programs
are appropriate venues for people with prediabetes to receive education
and support to develop and maintain behaviors that can prevent or delay
the onset of diabetes. C