Curriculum · Metabolic and Endocrine and Diabetes Mellitus
Impaired fasting glucose (prediabetes)
What it is
A fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l implies impaired fasting glucose, the prediabetic state. A patient with a fasting blood glucose of 6.7 mmol/l on 2 occasions therefore has impaired fasting glucose rather than diabetes. Impaired glucose tolerance is a separate category, defined as a fasting plasma glucose less than 7.0 mmol/l with an OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l.
Causes and risk
The listed risk factors for type 2 diabetes are a family history of diabetes, a BMI of 23.0 kg/m2 or more, an inactive lifestyle, high blood pressure, abnormal blood cholesterol or lipid levels, a history of gestational diabetes, being 40 years old or more, and having impaired glucose tolerance or impaired fasting glucose. Impaired fasting glucose is also one of the conditions all refugees should be screened for, along with anemia, hypertension, nutritional deficiencies, tuberculosis and COPD.