Both impaired fasting glucose (IFG) and impaired glucose tolerance are associated with an increased risk of developing diabetes and cardiovascular disease. Impaired fasting glucose is defined by the WHO 2011 as a fasting plasma glucose of ≥ 6.1mmol/L and the American Diabetes Association (ADA Clinical Practice Recommendations 2016) as a fasting plasma glucose ≥ 5.6mmol/L.
The WHO and ADA guidelines define pre-diabetes as an impaired fasting glucose level between 5.6 – 6.9mmol/L; and impaired glucose tolerance as the 2 hour plasma glucose from an OGTT between 7.8-11 mmol/L, or HBA1C between 39 – 47 mmol/mol.
Type 2 diabetes is the most common form of diabetes in adults. Risk factors include age > 40 years; family history of a first degree relative with diabetes; history of gestational diabetes; raised BMI; sedentary lifestyle; have known established hypertension or hyperlipidaemia; have established arterial disease (IHD, CVA, PVD); or have other clinical conditions associated with insulin resistance (PCOS, long term steroid use, severe obesity).
Type 2 Diabetes can be diagnosed if 2 of the following are present: a random blood glucose level of 11mmol/L; a fasting blood glucose level of > 7mmol/L; HbA1c 48mmol/mol or a glucose reading of >11.1 mmol/L at 2 hours after ingestion of glucose at an OGTT.
Globally, 537 million adults (20-79 years) are living with diabetes. 541 million adults have pre-diabetes, which places them at high risk of type 2 diabetes. The prevalence of diabetes worldwide is predicted to rise to 643 million by 2030 and 784 million by 2045.
