there are some clues to the diagnosis of type 2 diabetes (see the charter on "classification of diabetes). The most relevant are in the following table: Characteristics of subjects at risk of having type 3 diabetes: Age more than 45 ys Family history of type 2 diabetes Sedentary lifestyle High triglyceride level or low HDL cholesterol Some ethnic groups (afroamericans, Hispanics, Asians, American Indian) Females with a history of gestational diabetes or macrosomia To make a diagnosis of diabetes there are some requirements, as in the following table: Diagnosis   Diagnostic Glucose mg/dl   Diabetes mellitus (each method must be independently confirmed in a different day with another diagnostic method)   Fasting for more than 8 hs more than 126mg/dl   2H Oral glucose load of 75 g of glucose more than 199mg/dl   ü random finding More than 199 mg/fl plus symptoms of diabetes IGT (impaired glucose tolerance)   Fasting Less than 126 mg/dl   2H Oral glucose load of 75 g of glucose 140-199 IFG (Impaired fasting glucose)   Fasting 110-185 It is clear than that to say that to say that a person has diabetes an any alteration of the aforementioned parameters must be found, and such alteration must be confirmed on a second day As is evident from the table to say that a person has diabetes an any alteration of the parameters in the fist panel must be found, and this alteration must be confirmed on a different day. The parameters are a fasting glucose value more the 126 mg/dl, the 2-h post glucose Blood Glucose value or a random Blood glucose value plus symptoms more than 200 mg/dl. To make a diagnosis of Impaired glucose tolerance ( a state that confers a major risk of cardiovascular disease) a 2-h post OGTT between 110 and 125 is sufficient. It is also important to highlight the existence of another condition, the Impaired fasting glucose (IGF), yet not well known, that however seems to increase the risk of future cardiovascular disease: in this case the only diagnostic criterion is a blood glucose between of 110-125 mg/dl in the fasting state. On the basis of 30 - yr experience I think that some point could be made: 1- the IGT and IFG categories are a marker of increased cardiovascular risk and must be treated 2- a normal set of tests does not preclude a future progression towards diabetes irrespective of the blood glucose values, especially if they are in the high - normal range, if a person is obese, smoker or has some relatives with diabetes I could hardly define him "normal", I would watch him carefully and I would advice him to follow the same lifestyle of a diabetic