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Glucose Intolerance

Mariya Milko, MS, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Glucose intolerance is an intermediate stage between a normal glucose metabolism and diabetes. It occurs due to a gradual decline in ß-cell function.

  • Individuals with impaired fasting...

DIAGNOSIS

Who to screen 
  • BMI ≥25 or ≥23 for Asian Americans (1)[B]

  • Age ≥45 years (1)[B]

  • First-degree relative with diabetes

  • High TG >250 mg/dL

  • Low HDL <35 mg/dL

  • HTN: BP >140/90 mm Hg or on treatm...

TREATMENT

  • Therapeutic lifestyle modification to include physical activity focused on weight loss and medical nutrition therapy (preferably via a registered dietitian)

  • Mediterranean diet and diets high ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • At least annual monitoring for development of diabetes with HbA1c, 2-hour OGTT, or fasting glucose

  • BP should be routinely measured.

  • Annual testing...

REFERENCES

1
American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care.  2017;40(Suppl 1):S11–S24. [View Abstract on OvidMedline] ...

ADDITIONAL READING

Papaetis GS. Incretin-based therapies in prediabetes: Current evidence and future perspectives.  World J Diabetes. 2014;5(6):817-834.  

CODES

ICD10

  • E74.39 Other disorders of intestinal carbohydrate absorption

  • R73.09 Other abnormal glucose

  • R73.01 Impaired fasting glucose

  • R73.02 Impaired glucose tolerance (oral)

SNOMED

  • 9414007 Impaired glucos...

CLINICAL PEARLS

  • Patient education and lifestyle reinforcement should be emphasized in all clinical encounters as lifestyle optimization is essential for all patients with prediabetes.

  • Research shows th...

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