A group of health researchers have declared that labelling some people with pre-diabetes is both unhelpful and unnecessary. Pre-diabetes is defined as somebody who is close to developing type 2 diabetes.
Health researches have published in the Too Much Medicine section of British Medical Journal (see link below) to say that this definition has no clinical worth and should therefore being abolished.
However, Diabetes UK, a UK based charity, has said that it is a very useful way to highlight to people that they are at risk of developing type 2 diabetes.
Identifying people as being at high risk of developing of diabetes provides an opportunity for these people to make changes to their lifestyle, such as improving diet and becoming more active.
People with pre-diabetes have no symptoms of ill health however they do have high blood sugar levels and this is often a sign that problems are developing. High blood sugar is caused by a lack of insulin and insulin resistance.
The World Health Organisation does not recognise the term pre-diabetes even though it is used in many scientific papers and also by health advisers.
In 2010, The American Diabetes Association redefined pre-diabetes and this new definition of placed one-third of all adults in England and half of all those in China as being diabetic. It also predicts that one in ten people will develop type 2 diabetes every year.
Health researchers working at the Mayo Clinic in Minnesota said that pre diabetes risks and unnecessary medicalization and also creates unsustainable burdens for healthcare systems.
Prof John Yudkin who co-authored the report, said to BBC News: “Pre-diabetes is an artificial category with virtually zero clinical relevance”.
“There is no proven benefit of giving diabetes treatment drugs to people in this category before they develop diabetes, particularly since many of them would not go on to develop diabetes anyway.
“More people are being included in the medical category of pre-diabetes without the evidence that they are going to benefit from the interventions”.
However, Diabetes UK believes that this is a useful way to indentify when an individual is placing themselves at risk of developing full type 2 diabetes.
In the UK it is estimated that up to 18 million people are currently cream diabetic. To prevent these people developing type 2 diabetes health advisers need to be able to encourage them to become more active and consume a healthier diet. How can this be done without first identifying the risk?
Type 2 diabetes is a lifestyle disease; healthy eating and regular exercise prevents the disease. In fact it is lack of exercise and poor diets that causes type 2 diabetes. The development of diabetes is very closely linked with obesity.
To combat the disease education is required to teach people how to live healthier lives; this is one of the missions of MotleyHealth.
Only by teaching people how to exercise and how to eat healthily can we eradicate this disease. A combination of government intervention and education is the only way the effect change. Doctors need to be able to tell people that they are at risk of developing diabetes and “pre-diabetes” seems to be an effective label for this purpose.
What can you do instead?
The best way to avoid being labelled with Pre-Diabetes is the eat healthy, maintain a good weight and do some weight training. In 2011 we reported that increasing muscle mass is a good way to ward off the disease, so head to our weight training section and start lifting.
The epidemic of pre-diabetes: the medicine and the politics, by John S Yudkin and Victor M Montori. BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4485 (Published 15 July 2014).