1) The document discusses pre-diabetes, which affects over 230 million people worldwide and is a risk factor for developing type 2 diabetes and cardiovascular disease. 2) It reports on a study of 50 pre-diabetic patients in India that found annual progression to diabetes was 5% and major complications included 20% cardiovascular, 6% cerebrovascular, 8% peripheral vascular disease, and 8% retinopathy. 3) Lifestyle interventions including nutrition, physical activity and weight management are recommended to reduce the risk of developing diabetes. Drug therapy may also help delay onset of type 2 diabetes in some cases.

1. Dr. Awadhesh Sharma Study of Microvascular & Macrovascular Complications in Prediabetics (Impaired Glucose Tolerance)” Department of Medicine MLB Medical College, Jhansi

2. What is pre-diabetes? Pre-diabetes is a condition where blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes. Pre-diabetes is a key factor in the development of type 2 diabetes. However, n ot everyone with pre-diabetes goes on to develop type 2 diabetes. Pre-diabetes is characterized by disturbance in blood sugar levels as measured by impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Patients can have one or both of these conditions to be considered pre-diabetic.

7. Risk of Cardiovascular Disease Is Elevated Prior to Diagnosis of T2DM % with CVD *MI=myocardial infarction. Adapted from: Hu F, et al. Diabetes Care. 2002;25:1129-1134.

18. Our Study

20. Material & Methods The study entitled “ Study of Microvascular & Macrovascular Complications in Prediabetics (Impaired Glucose Tolerance) ” was conducted in the department of Medicine of M.L.B. Medical College, Jhansi from the period of June 2006 to September 2009. The cases were patients coming to Medicine OPD and in the emergency being admitted in the Medicine ward as cases of impaired glucose tolerance or prediabetes. Fifty patients of prediabetes were included in the study which are selected from Medicine OPD and those who admitted in the Medicine ward.

35. How we manage ?

36. Health Physical Activity + Sound Nutrition Good Health

37. Health The first part of our equation is activity Get moving, find something you enjoy

38. Health The second part of the equation is nutrition Your body needs the right fuel to help it work well.

39. How Can You Help Reduce Your Risk of Diabetes? Eat foods low in fat & calories. If overweight, lose weight.  Physical activity Stop smoking! Limit alcohol to 1-2 drinks per day. Take your medications regularly.

40. Encourage people to change habits . Use the pyramid guide to educate people to eat healthy.

41. Is drug therapy useful in patients with pre-diabetes? Drug therapy is not recommended by the ADA due to the limited efficacy of treatment versus lifestyle modification, potential for adverse drug reactions, lack of data supporting reduction of microvascular or macrovascular complications of diabetes in this patient population, and insufficient assessment of the cost-effectiveness of drug treatment. However, not all patients are able to implement lifestyle modifications due to physical or other limitations, and based on limited data available, drug therapy may be a reasonable option to delay onset of type 2 diabetes and provide a cardiovascular benefit (TRIPOD and STOP-NIDDM data).

42. THANK YOU