I have to say, I agree with Riva that pre-diabetes is just diabetes and we should stop beating around the bush. But I also am alarmed by her misunderstanding of T2 diabetes. We have a "huge" program called the Diabetes Prevention Program (DPP), which is now "the total solution." If you accept the premise that pre-diabetes is diabetes and carefully read the DPP study, you will realize that the study was fundamentally "rigged." It measured a false outcome. It didn't measure how many people still had diabetes, it simply measured whether their diabetes had progressed. In fact, in hindsight, one has to wonder whether the failure to report whether patients were still pre-diabetic even after following the low fat calorie restricted exercise regime was a "cover-up." And a recent study of the long-term effects of the DPP found "Overall, intensive lifestyle intervention achieved, with less medication, a comparable long-term effect on cardiovascular disease risk factors, to that seen in the metformin and placebo groups." Whoop-de-doo.
So does the DPP really help? I don't think we have any evidence. Does it "prevent?" I don't think so.
I think it is a house built on a cracked foundation and I am not happy with the vast sums of money being spent on this "final solution." Years from now, we may look back at this fiasco and feel ashamed of the harm done to millions of people worldwide.