You are prediabetic if your fasting blood sugar falls between 100-125 mg/dl or a 2-hour postprandial (after eating) blood sugar falls between 140-199 mg/dl according to the American Association of Clinical Endocrinologists (AACE). Worldwide, it is estimated that 314 million persons are prediabetic and that number is predicted to rise to 418 million by 2025.
The AACE has published their consensus statement on the subject -- Diagnosis and Management of Prediabetes in the Continuum of Hyperglycemia: When do the Risks of Diabetes Begin? -- and they want the problem to be aggressively treated with "intensive lifestyle intervention" being the most important component. They recommend:
Weight reduction of 5% to 10%, with long-term maintenance at this level
At least 30 to 60 minutes of moderate to intense physical activity at least five days per week.
A diet that includes calorie restriction, increased fiber intake and possible limitations in carbohydrate intake. Dietary recommendations specifically for blood pressure include lower sodium intake and avoidance of excess alcohol.
The task force also suggested a more aggressive approach to treating high-risk individuals with medications such as metformin, acarbose, glucagon-like peptide 1 agonists and thiazolidinediones.
The FDA has not approved any medications for specific therapy of prediabetes. However, many believe that judicious use of certain medications may be beneficial at this stage.