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A condition in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. People with prediabetes are at increased risk for developing type 2 diabetes, heart disease, and stroke.

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Around 308 million people worldwide are reported to have 'impaired glucose tolerance'. These individuals show higher than normal blood sugar (glucose) levels, but do not meet diagnostic criteria for having type 1 or type 2 diabetes. This may provide a window in which to prevent or delay the onset of diabetes and its complications like cardiovascular disease. Within a decade of the initial diagnosis 'impared glucose tolerance' 25% to 75% are estimated to progress to diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Alpha‐glucosidase inhibitors (acarbose, miglitol, voglibose) are drugs that delay the breakdown of carbohydrates in the gut, and consequently slow down the absorption of sugars. Patients with type 2 diabetes may use it therapeutically. People with a raised blood glucose level (without being a diabetes patient) may use this drug in order to prevent developing type 2 diabetes and diabetes related morbidity such as cardiovascular diseases. To find evidence for these assumptions, we searched the medical literature for randomised controlled trials of at least one‐year duration, investigating alpha‐glucosidase inhibitors for patients with impaired glucose tolerance (IGT) or impaired fasting blood glucose (IFBG). Patients with IGT or IFBG have raised blood glucose levels, but do not meet the criteria for having type 1 or type 2 diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

To assess the effects of reminder systems to increase uptake of testing for type 2 diabetes or impaired glucose tolerance in women with a history of gestational diabetes mellitus (GDM).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Bibliographic details: Santaguida P L, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H.  Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose: diagnosis. Rockville, MD, USA: Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment; 128. 200516194123

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in the UK and worldwide. Before the onset of T2DM, there are two conditions characterised by blood glucose levels that are above normal but below the threshold for diabetes. If screening for T2DM in introduced, many people with impaired glucose tolerance (IGT) will be found and it is necessary to consider how they should be treated. The number would depend on what screening test was used and what cut-offs were chosen.

Health Technology Assessment - NIHR Journals Library.

Version: August 2012

The SGLT 2 inhibitors (such as canagliflozin, dapagliflozin and empagliflozin) are glucose‐lowering drugs that reduce blood glucose levels by increasing the secretion of glucose from the kidneys to the urine. SGLT 2 inhibitors were recently approved for the treatment of diabetes in people with type 2 diabetes mellitus. It is currently not known whether SGLT 2 inhibitors should be prescribed for people with raised blood glucose levels who do not meet the criteria for having type 2 diabetes. We wanted to find out whether these drugs would prevent or only delay the development of type 2 diabetes. Furthermore, we wanted to analyse the effects of SGLT 2 inhibitors on patient‐important outcomes such as complications of diabetes (for example kidney and eye disease, heart attacks, strokes), death from any cause, health‐related quality of life and side effects of the medications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Report finds that the case for universal screening for type 2 diabetes mellitus in people aged > 40 years is not proven, although there is a case for selective screening as part of overall vascular risk assessment.

Health Technology Assessment - NIHR Journals Library.

Version: August 2013

Pre‐existing diabetes and gestational diabetes can increase the risks of a number of poor outcomes for both mothers and their babies. For the mother, these include pregnancy‐induced high blood pressure (pre‐eclampsia) with additional fluid retention and protein in the urine; and giving birth by caesarean. For the infant, these can include preterm birth; as well as an increased risk of the presence of physical defects at birth such as heart defects, brain, spine, and spinal cord defects, Down syndrome; and spontaneous abortion. Other complications at birth include babies that are large for their gestational age, and obstructed labour (shoulder dystocia) caused by one of the shoulders becoming stuck in the birth canal once the baby's head has been born.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

There is a need to identify biomarkers of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) risk in women with PCOS to facilitate screening and the development of novel strategies to prevent disease progression. Metabolomic technologies may address this need. All published studies on metabolomic biomarkers of IGT and/or T2DM identified through MEDLINE (1966-December 2010), EMBASE (1980-December 2010) and Cochrane (1993-December 2010) were retrieved. Eligible studies were screened and specific study characteristics recorded including study design, number of participants, selection criteria, type of metabolomic technique used, site of sample collection, and a list of metabolites identified to have been altered in IGT and/or T2DM versus healthy controls was created. Nine metabolomic biomarkers that could potentially be used to identify women with PCOS at risk of developing IGT and/or T2DM were identified including leucine, isoleucine, citrate, glucose, creatinine, valine, glutamine, alanine and HDL. Of these biomarkers, a panel of four biomarkers were consistently either elevated or reduced including glucose (elevated), valine (reduced), HDL (reduced) and alanine (reduced) in IGT/T2DM compared with controls. These biomarkers may predict the development of IGT/T2DM in young women with PCOS. More studies are required to test this hypothesis and translate the findings into patient benefit by reducing the morbidity/mortality associated with IGT/T2DM in PCOS.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

OBJECTIVE: To investigate whether antihypertensive treatment is beneficial to patients with diabetes mellitus when their blood pressure (BP) is below 140/90 mm Hg (1 mm Hg = 0.133 kPa).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

Although dapagliflozin, canagliflozin and empagliflozin improve glycaemic control, as monotherapy they are not cost-effective compared with gliclazide or pioglitazone, but may be against sitagliptin.

Health Technology Assessment - NIHR Journals Library.

Version: January 2017

This study finds that the routine identification of pregnant women for treatment of hyperglycaemia cannot be considered cost-effective given the absence of evidence of longer-term benefit.

Health Technology Assessment - NIHR Journals Library.

Version: November 2016

Some people have digestive problems after drinking milk or eating dairy products. They may only tolerate very small amounts of lactose because their bowel has trouble breaking it down.Lactose is the main carbohydrate in milk produced by cows and other animals. Human breast milk also contains lactose. It is not present in vegetable products like soy milk. Lactose consists of two sugars: glucose and galactose. An enzyme in our small intestine called lactase quickly breaks down the lactose into its two parts. Only after the two sugars have been separated can they be absorbed by our bowel.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 17, 2015

Type 2 diabetes mellitus (DM) is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness; a major cause of heart disease and stroke; and the seventh leading cause of death in adults in the United States. Screening could lead to earlier detection and earlier or more intensive treatment of persons with asymptomatic DM, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT), potentially resulting in improved clinical outcomes.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: April 2015

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year.

World Health Organization.

Version: 2016

The review concluded that most trials reported a significant reduction in diabetes incidence through lifestyle interventions for patients with impaired glucose tolerance but there was no improvement in mortality, morbidity or other known risk factors for diabetic complications. The authors’ conclusions reflect the data presented but limitations in review methods and available data make the reliability of the conclusions unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

This review concluded that, independent of the effects of diet or weight loss, the role of physical activity in the prevention of type 2 diabetes is equivocal. The authors’ conclusions should be interpreted with caution since all studies assessed a combined intervention of diet and exercise, thus it is not possible to comment on the contribution of exercise alone.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review concluded that lifestyle and pharmacological interventions reduce the rate of progress to type 2 diabetes in people with impaired glucose intolerance, and that lifestyle interventions seem to be at least as effective as drug treatment. The authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in the UK and worldwide. It is expected that the UK prevalence will increase by about 50% over the next decade. If not well managed it can have serious consequences. These include an increase in cardiovascular diseases (CVDs), such as heart disease, stroke and peripheral vascular disease, and in small vessel (microvascular) disease, which can cause blindness and renal failure. In addition to the human costs, such complications place a heavy burden on health-care resources.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2012

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