Management of Prediabetes

Recent studies have shown a rapid conversion of impaired glucose tolerance to diabetes in the southern states of India, where the prevalence of diabetes among adults has reached approximately 20% in urban populations and approximately 10% in rural populations.

Lifestyle modification is an effective tool for the primary prevention of diabetes in Asian Indians.

The primary prevention of diabetes is urgently needed in India to curb the rising burden of diabetes.

The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1)

Lifestyle modification helps in the primary prevention of diabetes in multiethnic American, Finnish and Chinese populations.

In a prospective community-based study, we tested whether the progression to diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than the above populations.

We randomised 531 (421 men 110 women) subjects with IGT (mean age 45.9+/-5.7 years, BMI 25.8+/-3.5 kg/m(2)) into four groups. Group 1 was the control, Group 2 was given advice on lifestyle modification (LSM), Group 3 was treated with metformin (MET) and Group 4 was given LSM plus MET.

The primary outcome measure was type 2 diabetes as diagnosed using World Health Organization criteria

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