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1. Cardiovascular mortality is increased 1.5 times in those with impaired glucose tolerance.

People with impaired glucose tolerance have a 6-fold increased risk of developing diabetes in the future. If a person has both impaired glucose tolerance and impaired fasting glucose, the risk of developing diabetes is increased 12-fold. Impaired glucose tolerance is therefore a pre-diabetic state.

Lifestyle changes are the most important interventions for those with impaired glucose tolerance. The Diabetes Prevention Program showed that exercise and attention to body weight could reduce the risk of developing diabetes. (NEJM 2002). A person with impaired glucose tolerance needs to be assessed for other features of the metabolic syndrome as part of an overall risk assessment. The diagnosis of impaired glucose tolerance should be taken as an opportunity to assess and advice on all cardiovascular risk factors.

Those with impaired glucose tolerance and a high cardiovascular risk – for example, a high Framingham risk score suggestive of a 20 percent risk of developing a cardiovascular event within ten years - can be offered treatment with Metformin for controlling plasma glucose.

There is evidence that drugs like Metformin, Acarbose and Rosiglitazone can help prevent diabetes in those with impaired glucose tolerance.

Reference:
Metformin for prevention of diabetes
Acarbose for prevention of diabetes
Rosiglitazone for prevention of diabetes
Diabetes Prevention Program

2. An oral Glucose Tolerance Test is recommended by the World Health Organisation for further evaluation of patients who are considered to have impaired glucose tolerance. In pregnancy, a glucose tolerance test is done to diagnose gestational diabetes in women who are at high risk of diabetes.


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