Prediabetes is a label that is unhelpful and unnecessary

[DCUK NewsBot]

A joint team of British and American researchers claim that labelling people as having prediabetes is 'unhelpful and unnecessary'. Prediabetes, also referred to as borderline diabetes, is often a precursor to developing type 2 diabetes. The researchers, writing in the British Medical Journal, state that many of those labelled as having prediabetes will not develop type 2 diabetes. For that reason, the researchers claim that there is no proven benefit of prescribing drugs. People with prediabetes will often have no symptoms of the condition other than having blood glucose at the higher end of the normal blood glucose range. Although the World Health Organisation does not officially recognise the term prediabetes, it is used frequently in research papers. The news comes a month after research also published in the British Medical Journal last month stated that 1 in 3 adults are living with prediabetes in England. Prof John Yudkin of University College London, reportedly stated that the current definitions of prediabetes risks "unnecessary" medicalisation and created "unsustainable burdens" for healthcare systems. A fasting plasma glucose test or an HbA1c test may be used to diagnose prediabetes. If test results are above the ceiling for prediabetes, a type 2 diabetes diagnosis may be given or further tests may be required. Over 3 million people have type 2 diabetes in the UK and Diabetes UK estimates that figure will rise to 5 million in the next 10 years.

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[Alan S]

For a long time many of us on various diabetes forums have known that the diagnostic criteria for pre-diabetes (or IGT and IFG) are well past the point on the continuum where the condition may be reversible. Thus pre-diabetics have already developed diabetes. Therefore I believe this is bloody nonsense until I see a peer-reviewed paper confirming their guess that pre-diabetics, without lifestyle or medication intervention, will not eventually and almost inevitably progress to complications. At best, failing to modify lifestyle at an early stage and waiting until the threshold of 7mmol/l FBG or 6.5% A1c is reached will lead to a significant number already having complications by the time they are diagnosed.

This is yet another piece of nonsense which will almost certainly be used to limit testing supplies and probably medications to NHS clients.

That is my first reaction. When I get time I'll go deeper into the detail on BMJ.