September 30, 2014

Change May Be Coming for Prediabetes

Yes, it may still be a few years in the future, but if researchers continue to make their voices heard, the American Diabetes Association (ADA) may feel the pressure. At present, the ADA has not given much attention to prediabetes and the term has caused most doctors to ignore prediabetes since it has no real official status. Even the medical insurance industry gives it no support.

I will quote the lead-in to the Science Daily article as it expresses what needs to be said about prediabetes.

Treating patients with prediabetes as if they had diabetes could help prevent or delay the most severe complications associated with this chronic disease, experts say. The researchers say that by not devising a treatment strategy for people with prediabetes, doctors run the risk of creating a pool of future patients with high blood sugar who then become more likely to develop serious complications, such as kidney disease, blindness, amputations, and heart disease.”

It seems that most doctors want to create a pool of future patients with high blood glucose levels. This may be the reason for the ADA not classifying prediabetes as diabetes and making it an official part of diabetes classification types. The term needs to go and be renamed, as outlined in my previous blog, Suggestions for ADA, but with more researchers recognizing the need, something may be done in the future and hopefully the near future.

According to the study authors, evidence comes from clinical trials where lifestyle change and/or glucose-lowering medications decreased the progression from prediabetes to type 2 diabetes. After leaving the interventions, the development of diabetes remained less in people who changed their lifestyle and/or took medications compared to the control group of prediabetes patients who did not have interventions.

The study authors say, “First, adults should be screened systematically to find prediabetes and early type 2 diabetes. And second, patients who are likely to benefit from treatment should have management aimed to keep their blood glucose levels as close to normal as possible.”

Lead author of the editorial, Lawrence Phillips, MD, from Emory University said, "Diabetes is generally diagnosed and first treated about ten years later than it could be. We waste this critical opportunity to slow disease progression and the development of complications. There is a strong, new argument that by combining screening to find prediabetes and early diabetes, along with management aimed to keep glucose levels as close to normal as possible, we can change the natural history of the disease and improve the lives of our patients."

Note: I will have another blog about the other side of diabetes which is not favorable for anything but more speculation. Hopefully, it will be ready next week.


Ila East said...

A lot of people say there is no such thing as predisbetes. The thing is that with diabetes as with a lot of other conditions, there is an arbitrary number that says anything above means a person has the condition and below they don't.

In actuality, that number means above and we treat and below we don't treat. To me it's plain and simple.

Bob Fenton said...

In assigning arbitrary numbers, often much is lost as people are individually different and the variables unpredictable.

There is much to gain by considering recent diagnosis research and reevaluating what it could mean for people above certain blood glucose levels.

The diabetes risk factors are ;left out of the equation in favor of arbitrary numbers. The one-size-fits-all treatment does not work.