"Prediabetes is a dangerous state. It is associated with an increased risk of cardiovascular, small blood vessel and microvascular complications. The risks begin before diabetes is established, and therefore we need to treat it. Compliance with lifestyle interventions is usually poor. If lifestyle is not sufficient or if there is rapid beta cell failure, then aggressive pharmacology may be the best choice for first line therapy." Dr. Alan Garber, MD, PhD said. These new recommendations come as a result of the prediabetes consensus conference. These new clinical recommendations include specific instructions for lifestyle intervention and medication.

Opening session speaker, AACE Vice President Daniel Einhorn, MD, FACP, FACE also suggested a more aggressive approach to treating patients in high-risk groups with medications including metformin, TZD's, DPP4 and GLP1. He said, "These medications illustrate a specific 'plan of attack' for treating prediabetes. But it's important that caution is exercised." Dr. Einhorn suggested A1c levels should be considered as a diagnostic tool. "An A1c level of 6.0 to 6.5 indicates treatment for prediabetes with certain caveats. Lifestyle intervention should be the cornerstone of treatment for all patients," Einhorn said. "And it should be reinforced with each visit to the doctor."

Conclusion — Don't take prediabetes lightly. Treat it as though it is diabetes. In time, we may even be using the same diagnostic criteria for diabetes as we do now with prediabetes.