What office-based interventions are effective for treating abnormal glucose levels or preventing progression to type 2 diabetes?

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EVIDENCE-BASED ANSWERTelemedicine interventions—including telephone and Internet-based monitoring and education—result in a slight reduction in glycated hemoglobin (HbA1C) in patients with diabetes (SOR: C, meta-analysis of RCTs with disease-oriented outcomes). In patients at risk for diabetes, an intensive lifestyle-based intervention that includes case managers, education, and other individualized forms of support reduces the incidence of diabetes by 58% over 3 years (with continued but less effect over 15 years), reduces the prevalence of microvascular disease among women, and is superior to metformin alone (SOR: B, RCT and large cohort study).

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