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Am Fam Physician. 2022;105(4):438-439

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Prediabetes is not a diagnosis but rather an opportunity to prevent or delay a future diagnosis of type 2 diabetes.

• Intensive lifestyle programs are the most effective intervention for preventing or delaying a diagnosis of diabetes in patients with prediabetes.

• In patients with prediabetes, metformin therapy will slow the progression to type 2 diabetes, although less effectively than lifestyle programs over time.

• In patients who have had gestational diabetes, the benefits of metformin therapy are similar to those of lifestyle programs.

From the AFP Editors

Screening high-risk individuals for diabetes mellitus is essential because approximately one-fourth of Americans with diabetes are undiagnosed. The American Diabetes Association (ADA) recommends screening all adults 45 years and older for diabetes every three years using A1C, fasting glucose, or two-hour glucose tolerance testing. People younger than 45 years who are overweight or obese and are at high risk because of a family history, certain medical conditions (e.g., cardiovascular disease, hypertension, dyslipidemia, polycystic ovary syndrome), or physical inactivity and those who belong to a high-risk racial or ethnic group (i.e., African American, Latino, Native American, Asian American, and Pacific Islander) or who have signs of insulin resistance (e.g., severe obesity, acanthosis nigrans, small-for-gestational age birth weight) should also receive regular testing.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, associate medical editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

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