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I understand the need to identify patients with diabetes at the earliest opportunity however to incorrectly diagnose diabetes is as inappropriate as to miss it. To give a patient a diagnosis of diabetes has all sorts of insurance/cost implications and may result in them recieving inappropriate medication. Your concerns about early diagnosis are understandable but should not be at the expense of over diagnosisng diabetes. In terms of risk stratification even those with "pre-diabetes" are at an increase risk of cardiovascular disease over the normal population (but less than the diabetic population) so even if your patient is subsequently found not to have diabetes and had pre-diabetes he/she should have their lipids/Bp etc treated aggressively.