Fast plasma glucose of 6.9 mmol/l is considered prediabetes, an abnormal stage of glucose metabolism between diabetes and normal blood glucose levels. People with prediabetes should ideally control their blood glucose levels to those of normal people. If they are unable to reach normal levels of glucose tolerance, they should at least try to remain in prediabetes and try to avoid its progression to diabetes.
Interventions for prediabetes:
1. Preferred lifestyle interventions: (1) weight control to a normal body mass index (<24 kg/m2) or at least a 5% to 10% weight reduction is recommended for those who are obese or overweight; (2) total daily dietary calorie reduction of at least 400 to 500 kcal; (3) saturated fatty acid intake of less than 30% of total fatty acid intake (4) increased physical activity to 250-300 min/week.
2. Pharmacologic therapy: (1) if one finds it difficult to adhere to weight loss and exercise or if strict lifestyle interventions are not effective for more than 6 months and blood glucose remains poorly controlled (fasting glucose >6.1 mmol/L); (2) or if hyperglycemia progresses and one is young, well-off, and has higher health needs and medical conditions; pharmacologic therapy can be considered. Metformin is recommended. If metformin is not tolerated, acarbose or thiazolidinediones may be used. All of these drugs should be administered under the guidance of a physician and adjusted to the appropriate dose with strict monitoring of blood glucose.