Peer Reviewed
Feature Article Diabetes
Does your patient have glucose intolerance?
Abstract
Persons with impaired glucose tolerance are at very high risk of developing type 2 diabetes. Several recent successful interventional studies targeting subjects with impaired glucose tolerance have stimulated enthusiasm for prevention of type 2 diabetes.
Key Points
- In the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), the prevalence of impaired glucose tolerance (IGT) in adults was 10.6%. This translates to almost 1,300,000 people.
- If the fasting plasma glucose is between 5.5 and 6.9 mmol/L, or the random blood glucose is between 5.5 and 11.0 mmol/L, an oral glucose tolerance test is recommended.
- Detection of IGT, an asymptomatic condition, is unlikely to provide optimal benefit unless it is accompanied by a comprehensive health assessment that includes consideration of obesity, blood pressure and serum lipids.
- People with IGT are at very high risk of developing type 2 diabetes, and lifestyle intervention studies into preventing diabetes have targeted these people.
- The principles of successful lifestyle interventions for diabetes prevention are weight loss, regular physical activity and a fibre-rich diet tin which less than 30% of total energy is fat and less than 10% of total energy is saturated fat.
- The use of pharmacological agents for type 2 diabetes prevention is being explored.
- Longer-term follow up studies are needed to establish whether lifestyle and pharmacological interventions actually prevent type 2 diabetes or merely delay its onset.
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