The evolution of diabetes from prediabetes.

Temporary stress-induced undue hyperglycaemia following an oral carbohydrate load taken during hospitalization is being tested as a possible indicator of prediabetes. Observations in patients 15 months after hospitalization have permitted us to compare the blood sugar, insulin and growth hormone patterns evoked by an oral glucose load before and after glucose intolerance has appeared, viz. to speculate upon the evolution of diabetes from prediabetes. Though the numbers of such instances are as yet limited, they already suggest several possible sequences. Thus, our data support the concept that glucose intolerance, in addition to stemming from a decrease in insulin levels, can develop with true increases or with no evident decrease in the insulin responses to oral glucose. The simplified in-hospital carbohydrate tolerance test employed in assembling groups of possibly prediabetic individuals is also an efficient means of detecting permanent glucose intolerance of the diabetes mellitus type.