July 14, 2016
Many Whining about Prediabetes Initiative
I don't understand why so many professionals in the medical community and patients are whining about the prediabetes initiative promoted by the ADA, the American Medical Association (AMA), and the Centers for Disease Control and Prevention (CDC). Yet, in the July 11 issue of the Wall Street Journal, we have something laid out for us. Sensationalized? Yes! Still this reflects some of what I have heard. The biggest fallacy in the article is saying at the top that it is the government that is promoting this, when the CDC was the only government agency involved with the initiative.
The doctors quoted in the article say this screening of millions of people risks over diagnosis of the condition and could cause needless fears. Then the article starts out by explaining was a woman says, “Honestly, I wish I didn’t know. I mean for me, because I’m healthy, there’s not much I can do besides have the stress in my head. Every time I eat something now I’m worried.”
The article uses “experts” to say prediabetes, or blood-sugar levels that are higher than normal, but not high enough to qualify as diabetes, is often best left undiagnosed.
It is known that more than 1 in 3 adults in the U.S. have prediabetes, 90 percent of whom aren't aware of it. Without intervention, between 15% and 30% of these people will develop type 2 diabetes within five years.
This is probably one of the few times I will ever agree with Dr. Robert Ratner when he says, “What is the impact of telling somebody you have prediabetes and an increased risk of diabetes? Number one, you get their attention and get them to pay attention to their lifestyle. What’s the downside of a better lifestyle?”
Then the article turns to the “experts” who say the bar is set too low on what level of blood sugar should define prediabetes. Moreover, the number of people with the condition who will develop Type 2 diabetes is far lower than the 30%.
“Most people with prediabetes have blood-sugar levels at the low end of the range - between 5.7% and 6.0%, says the Mayo Clinic’s Dr. Montori. Studies show only about 5% of people with A1C levels of 5.7% or 5.8% will progress to Type 2 diabetes within five years, and very few progress after that, he says.”
Nit picking is my answer, as this says nothing about the rest between 6.0% and 6.5% that he leaves out.
“Stop worrying. Don’t worry below 6” on the A1C scale, says Dr. Richard Kahn, a professor of medicine at the University of North Carolina. He says he suggests people who are overweight or obese to lose weight, not just those with prediabetes.”
Then in the comments section, you need to exclude those that complain about the actions of the government and go ballistic about this. I will quote two comments I found that speak for many.
Quote: First - Most Doctors/patients think of Disease as an All or none phenomenon. A significant number of people already have Heart blockage by the time they are diagnosed technically with Diabetes. We do not develop High BP or Diabetes (or even cancer) overnight. Our BP/Sugar level rises in fits/starts, in most but not all instances, over several years (maybe as long as 10 years). The damage to our various organs similarly occurs over this time period long before the "Official Diagnosis". Of course, medicines are not indicated during this period. However, lifestyle changes, incl healthier eating habits/exercise/stop smoking etc., can help delay/prevent Diabetes/Hypertension and Heart disease. Personally, I would like to know if I have Prediabetes; then I have the choice of ignoring it or taking actions to prevent Diabetes.
Second - I do not understand not wanting to improve your health and preventing vs treating. 5 years ago I was approaching pre-diabetes. At advice of my Mayo MD I joined the Y, enrolled in the Diabetes Prevention Program, lost 50 lbs which I have kept off, learned a lot about nutrition. I am an advocate for that program & have urged many to enroll, & been a poster child for them with my success.. I was somewhat healthy before, now I am better than ever & often thought to be far younger than my 71 years age. Most people who are overweight are walking time bombs, why not get healthier, it takes work, but so worth it. Yes, a lifestyle change, not a diet. Unquote