A recent meta-analysis has confirmed that interventions in patients with pre-diabetes reduce the rate of progression to overt diabetes, but found that the screening tests used to identify pre-diabetes are inaccurate. The study was commissioned by policy makers in a London borough who wanted to identify an effective screen and treat policy in an area of high diabetes prevalence. The UK investigators trawled through Medline, PreMedline and Embase for eligible papers evaluating the accuracy of tests for pre-diabetes, and controlled studies of interventions (lifestyle changes or metformin) in pre-diabetes patients identified by screening. A total of 2,874 titles were scanned and 148 eligible papers reviewed. The final analysis included 49 studies of screening tests and 50 intervention trials.