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Diabetes mellitus (hereafter called diabetes) is a chronic illness which requires continuous medical care, and its prevalence continues to rise among developed countries. Shaw et al. estimated that the prevalence of diabetes among adults (aged 20-79 years) was 6.4% of the world population affecting 285 million adults in 2010, and will increase to 7.7%, 439 million adults by 2030. This diabetes epidemic places financial burden on most industrial nations. The direct medical cost of diabetes in the United States was estimated to be $116 billion in 2007. Thus, it is crucial to prevent onset of diabetes before it requires substantial medical resources because of its complications. Recently, a group of individuals whose glucose levels, although not meeting the criteria of diabetes, are too high to be considered as normal are defined as having prediabetes. Zhang et al. found that prediabetes is a strong predictor to progress to diabetes in the future. Using the Stern and Framingham risk estimates, Ackermann et al. estimated that the probabilities for incident of type 2 diabetes (over 7.5 years) and cardiovascular disease (CVD, over 10 years) were 33.5% and 10.7% respectively among adults meeting the 2003 American Diabetes Association (ADA) definition for prediabetes. Perreault et al. pointed out that reversion to normal glucose regulation from prediabetes is significantly associated with a reduced risk of future diabetes. Also, Pour et al. confirmed that lifestyle intervention (e.g., diet and exercise) for prediabetes can significantly reduce the incidence of type 2 diabetes.
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