Prediabetes: understanding non-diabetic hyperglycaemia

Prediabetes is a term that embraces various states of  hyperglycaemia that fall short of reaching the criteria for diabetes. Alternative terms describing prediabetes are non-diabetic hyperglycaemia, intermediate hyperglycaemia and impaired glucose regulation. 

This article uses the term prediabetes and aims to cover the definition, risk factors and prevalence of the condition, and why recognition is important. Management of prediabetes is discussed including the role of the Diabetes Prevention Programme.

Defining prediabetes

The most convenient method for defining prediabetes is an HbA1C in the range 42-47 mmol/mol (6.0 – 6.4%), the diagnostic threshold for diabetes being 48 mmol/mol.¹ Fasting plasma glucose is an alternative – be aware of the lower threshold for diagnosis that has now been adopted (see table 1). Less commonly an oral glucose tolerance test may be used.