1. Insulin Resistance Progression to Diabetes

2. Hypertension: BP >140/90 Dyslipidemia: ◦TG >150 mg/dL (1.7 mmol.L) ◦HDL-C <35 mg/dL (0.9 mmol/L) Obesity (central): BMI >30 kg/M2 ◦Waist girth > 94 cm (37 inch) ◦Waist/Hip ratio > 0.9 Impaired Glucose Handling: IR, IGT or DM ◦FPG >110 mg/dL (6.1 mmol/L) ◦2 hr. PG >200 mg/dL (11.1 mmol/L)

3. Inflammation

4. Stage 1 – Early Insulin Resistance

5. Treatment recommendations for Stage 1

6. Stage 2 – Elevated Insulin Graph represents patient's stage of pre- diabetes.

7. Treatment recommendations for stage 2

8. Stage 3: Beta-Cell Dysfunction Graph represents patient's stage of pre-diabetes.

9. Treatment recommendations for stage 3

10. Inflammation Markers High-sensitivity C-Reactive Protein (hs-CRP) High hs-CRP associated with: Chronic inflammatory state. Insulin resistance (independent of obesity) and increased risk of type 2 diabetes. Hypertension, metabolic syndrome, and aging. Increased risk of coronary artery disease, peripheral artery disease, and increased risk of cardiac death in individuals with previous heart attack.

11. Treatment Options to reduce hs- CRP: