Course Step-by-step plan: Preventing diabetes in high-risk patients

1. Step 1: Familiarizing yourself with the diagnostic thresholds for impaired glucose regulation (IGR)

1.1 Three types of glucose regulation

1.2 Table 1: Diagnostic criteria for diabetes and impaired glucose regulation

1.3 Causes of impaired glucose regulation

2. Step 2: Identification of individuals at highest risk of impaired glucose regulation

2.1 How common is impaired glucose regulation?

2.2 What are the consequences of impaired glucose regulation?

2.3 What are the risk factors for impaired glucose regulation?

3. Step 3: Identifying and managing diabetes risk - two-step approach

3.1 Stage 1: Risk assessment for type 2 diabetes (T2DM)

3.2 Advice and approach for low or medium risk scores

3.3 Stage 2: Blood test

4. Step 4: Perform a blood test for HbA1c or fasting plasma glucose in high-risk individuals

4.1 Blood test: Criteria & options

4.2 Table 2: Factors that may lead to misleading HbA1c results

4.3 Interpretation of the blood test: Does the patient have impaired glucose regulation?

5. Step 5: Be aware of the evidence regarding lifestyle changes and medication

5.1 Diabetes prevention: Effective interventions and lifestyle changes

5.2 Studies with effective interventions

5.3 Studies with effective interventions: Comprehensive research data

5.4 Effectiveness of lifestyle change: Research results in a nutshell

5.5 Dietary intervention

6. Step 6: Advising your patients on exercise and weight loss strategies

6.1 Counseling for lifestyle change

6.2 NICE lifestyle interventions

6.3 Key criteria for intensive programs

6.4 HALT2DIABETES prevention program in Flanders

7. Step 7: Determining the start of medication

7.1 Metformin

7.2 Orlistat

7.3 GLP-1 analogs

7.4 Raising patient awareness about the importance of adherence

8. Step 8: Monitoring progress and reconsidering diagnosis

8.1 Regular evaluation of patients with impaired glucose regulation

8.2 Postnatal glucose testing

8.3 Removing the diagnosis of pre-diabetes