Objective: To present the challenges of undiagnosed pre-diabetes, diabetes and associated cardiovascular disease. Results: A substantial number of people with diabetes and pre-diabetes remain undiagnosed worldwide. Without preventive measures, pre-diabetes progresses to overt diabetes at the rate of approximately 5% per year. Both diabetes and pre-diabetes are associated with vascular complications. Conclusion: Undiagnosed pre-diabetes and diabetes is a major health problem, and we recommend widespread screening for diabetes. An international expert committee has recommended that HbA1c be used for the diagnosis of diabetes. Further studies are needed before HbA1c can be used as a diagnostic test for gestational diabetes. © 2009 International Journal of Diabetes Mellitus.
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