There are challenges associated with the early and accurate diagnosis for pre-diabetes/intermediate hyperglycaemia (IH), particularly as it is often asymptomatic. However, far from being a benign ‘pre-disease’, pre-diabetes/IH increases an individual’s risk of developing several debilitating and life-threatening complications (including cardiovascular disease [CVD], kidney disease and type 2 diabetes). Early, and accurate screening helps identify those high-risk individuals with early insulin resistance and reduced ß-cell function who would benefit from early interventions (e.g. gestational diabetes mellitus or polycystic ovarian syndrome, overweight, older age) in order to provide effective intervention to reverse or slow the progression of pre-diabetes/IH to type 2 diabetes. The latest guidance given in the International Diabetes Federation (IDF) Position Statement [Bergman, 2024] reviews the 1-h plasma glucose (PG) test as a diagnostic biomarker assay that can more efficiently and accurately improve pre-diabetes/IH diagnosis earlier than the 2-h PG test, and with a reduced likelihood of misclassification of the glycaemic status of the individual. The incidence of CVD and kidney disease is greatly increased in patients with pre-diabetes/IH and the 1-h plasma glucose test has been strongly correlated with predicting the risk of either CVD or renal disease [Peng, 2024].