Prediabetes: Awareness Is Key!
Lilly Ostrovsky, MS

Before diabetes, there is prediabetes! Take a moment to appreciate the significance of this statement; it speaks volumes.
If prediabetes almost always precedes diabetes, awareness and appropriate management of prediabetes may not only delay the onset of diabetes but also prevent it.1

Unfortunately, awareness of prediabetes in the United States is low.2 According to a recent report from the Centers for Disease Control and Prevention, during 2009-2010, only 11% of people with prediabetes were aware of it2; this a slight jump from 7% in 2005-2006.3 Overall, between 2005 and 2010, less than 14% of individuals were cognizant of their prediabetes status.2 The report showed that age was an important indicator of prediabetes awareness; awareness was more common in the older population than in the younger.2

Prediabetes—a risk factor for both diabetes and cardiovascular disease (CVD)—is typically diagnosed using 1 of 3 parameters: fasting plasma glucose, oral glucose tolerance test (OGTT), or hemoglobin A1c (HbA1c).4

An important question remains: When should testing for prediabetes begin if patients are asymptomatic? The American Diabetes Association recommends prediabetes testing in adults of any age who are overweight or obese and who have 1 or more additional risk factors for diabetes; in those without these risk factors, testing should begin at age 45.4

Once prediabetes is diagnosed, healthcare professionals are urged to inform patients of their increased risk for diabetes and CVD and to discuss management strategies to lower their risk.4 Sharing this information with patients can be crucial to their health outcomes, as multiple studies have shown that lifestyle modifications—including changes in dietary and exercise habits—may reduce risk of diabetes.1,5


  1. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
  2. Awareness of prediabetes—United States, 2005–2010. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep. 2013;62(11):209-212.
  3. Geiss LS, James C, Gregg EW, Albright A, Williamson DF, Cowie CC. Diabetes risk reduction behaviors among U.S. adults with prediabetes. Am J Prev Med. 2010;38(4):403-409.
  4. American Diabetes Association. Standards of medical care in diabetes–2013. Diabetes Care. 2013;36 Suppl 1:S11-S66.
  5. Lindström J, Peltonen M, Eriksson JG, et al. Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia. 2013;56(2):284-293.
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