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In patients who meet criteria for “prediabetes” (i.e., impaired fasting glucose or impaired glucose tolerance), lifestyle and pharmacologic interventions can lower risk for progression to diabetes (JW Gen Med Feb 19 2002). However, we know little about metabolic changes that precede prediabetes.
Researchers enrolled 6538 nondiabetic British civil servants who underwent oral glucose tolerance tests and other metabolic analyses at baseline and at 6 and 11 years later; 505 developed diabetes during the study. During an average 13 years of observation, participants who did not develop diabetes had slight rises in fasting and postload glucose levels, constant insulin secretion, and slight declines in insulin sensitivity. By comparison, future dia…