Prediabetes or Categories of Increased Risk for Diabetes

Clare J. Lee, M.D., MHS, Rachel Derr, M.D.

Prediabetes or Categories of Increased Risk for Diabetes is a topic covered in the Johns Hopkins Diabetes Guide.

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DEFINITION

Isolated impaired fasting glucose (IFG) and isolated impaired glucose tolerance (IGT) are intermediate states of abnormal glucose homeostasis between normal and overt diabetes.
Prediabetes is an unofficial designation including either IFG, IGT or both.
Documentation of IFG requires only a fasting plasma glucose. Documentation of IGT requires a 75-gm oral glucose tolerance test.
A hemoglobin A1c of 5.7 - 6.4% identifies individuals in "categories of high risk for diabetes" to whom the term "prediabetes" may be applied (ADA Standards of Medical Care in Diabetes)[4].
See Table Table 1 for exact definitions.

Table 1
State	Fasting Glucose (mg/dl)	2 hour Glucose (mg/dl) during a 75g OGTT	A1c (%)
Normal	< 100	< 140	< 5.7
Isolated Impaired Fasting Glucose*	100-125	< 140	-
Isolated Impaired Glucose Tolerance	< 100	140-199	-
Combined IFG and IGT	100-125	140-199	-
Prediabetes or Categories of Increased Risk**	100-125	140-199	5.7 - 6.4
Diabetes**	≥ 126	≥ 200	>6.5

* The WHO and IDF recommend that Impaired Fasting Glucose be 110-125 mg/dl
**At least one criteria needs to be satisfied for diagnosis

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DEFINITION

Isolated impaired fasting glucose (IFG) and isolated impaired glucose tolerance (IGT) are intermediate states of abnormal glucose homeostasis between normal and overt diabetes.
Prediabetes is an unofficial designation including either IFG, IGT or both.
Documentation of IFG requires only a fasting plasma glucose. Documentation of IGT requires a 75-gm oral glucose tolerance test.
A hemoglobin A1c of 5.7 - 6.4% identifies individuals in "categories of high risk for diabetes" to whom the term "prediabetes" may be applied (ADA Standards of Medical Care in Diabetes)[4].
See Table Table 1 for exact definitions.

Table 1
State	Fasting Glucose (mg/dl)	2 hour Glucose (mg/dl) during a 75g OGTT	A1c (%)
Normal	< 100	< 140	< 5.7
Isolated Impaired Fasting Glucose*	100-125	< 140	-
Isolated Impaired Glucose Tolerance	< 100	140-199	-
Combined IFG and IGT	100-125	140-199	-
Prediabetes or Categories of Increased Risk**	100-125	140-199	5.7 - 6.4
Diabetes**	≥ 126	≥ 200	>6.5

* The WHO and IDF recommend that Impaired Fasting Glucose be 110-125 mg/dl
**At least one criteria needs to be satisfied for diagnosis

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