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Prediabetes Treatment Algorithm by Line of Therapy At a glance Diagnosis criteria / A1c 5.7-6.4%, fasting glucose 100-125 mg/dL, or 2-hour OGTT 140-199 mg/dL Annual conversion rate / roughly 5-10% of prediabetic adults progress to type 2 diabetes each year First-line therapy / structured lifestyle modification targeting 7% weight loss and 150 min/week moderate activity DPP trial result / lifestyle intervention reduced diabetes incidence by 58% over 2.8 years Second-line pharmacotherapy / metformin 1,500-2,000 mg/day for high-risk subgroups Metformin NNT / 14 patients treated over 3 years to prevent one case of diabetes Screening interval / repeat A1c or fasting glucose every 6-12 months while prediabetic Comorbidity screening / lipid panel, blood pressure, and cardiovascular risk assessment at diagnosis Guideline concordance / ADA, AACE, and Endocrine Society all endorse lifestyle-first approach How Prediabetes Is Diagnosed Three laboratory criteria define the condition: a hemoglobin A1c between 5.7% and 6.4%, a fasting plasma glucose of 100 to 125 mg/dL, or a 2-hour oral glucose tolerance test (OGTT) value of 140 to 199 mg/dL

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I advise my patients to stop a week before surgery for all patients and for all cases

A small molecule targeting ALOX12-ACC1 ameliorates nonalcoholic steatohepatitis in mice and macaques

We next asked the question whether the regulation of the ISR by cystine is mTORC1dependent