Prevalence of type 2 diabetes:

Pre diabetes is the new buzz word. Newspaper articles telling people overweight to watch out or they will become diabetic. I think this is propaganda from the Government. I was diagnosed diabetic three years ago and am now informed that I am pre diabetic. Changing diet etc seems to work and frightening people is they way forward to a healthier lifestyle.l

Looking back these days, I'm certain that I was on the diabetic scale - or pre-diabetic call it what you will - for quite a number of years before my diagnosis which arose out of a quite random health check nine years ago that found a fasting blood glucose level just over 7.

At one time of my life, nurses at the place where I worked used to comment on how low my blood pressure was - "LLike that of an athlete they used to say!" I used to like that! :lol: Then all of a sudden, it was checked again and they said that it had increased dramatically. About the same time, I had my first ever non-fasting total cholesterol check and that came back at a very high 9.74. About the same time, I started to have skin tags and I've read that these too may be linked to diabetes or carbohydrate intolerance - also, I started with and floaters in the eyes and understand that these might be related too.

From what I have learnt recently, it is likely that all these things have been linked and that my Type 2 diabetic condition could have been predicted well in advance of when it was.

However, I'm far from certain that the health authorities want to discover a whole new sector of our society who are in the very early stages of Type 2 diabetes. After all, they aren't doing a very good job of sorting out those Type 2s who are in a more advanced state of the condition!

Perhaps, that is why they keep changing the goalposts as to what they define as pre-diabetic, diabetic etc. Maybe, I'm just being too cynical?

What is pre-diabetes ?
Pre-diabetes is almost always a precursor to the development of type 2 diabetes. It is characterised by the presence of higher than normal blood glucose levels that are yet to reach diabetic levels. The scale of the problem is enormous and growing, as Western society and diet becomes more pervasive. In the United States alone there are over 40 million people suffering from the pre-diabetic condition.
The grey area between Diabetes and 'normal' levels. An Americanism, but it neatly sums it up.

This sites pages about Pre-Diabetes.
http://www.diabetes.co.uk/pre-diabetes.html

I don't think there is any propaganda involved. Though some people need a good 'jolt' to make them see sense where Diabetes is concerned. Complacency kills.

Hi Ken,

I just took a look at the relevant page in this forum and I quote:

"Pre-diabetes is a serious medical condition that can be treated. The good news is that the recently completed Diabetes Prevention Program study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range."

Aren't these people simply well-controlled diabetics in the same situation as I find myself?

John

Thanks a million for posting that Greg!
This place has been a huge asset to diabetics here and abroad, but your post really brings it home. There are millions of people in the UK eating their way to metabolic syndrome and diabetes with the active encouragement of the official agencies. We need people like you and the members here to show them how it ought to be. Nice one!

All the best,

fergus

wallycorker said:

Hi Ken,

I just took a look at the relevant page in this forum and I quote:

"Pre-diabetes is a serious medical condition that can be treated. The good news is that the recently completed Diabetes Prevention Program study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range."

Aren't these people simply well-controlled diabetics in the same situation as I find myself?

John

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Not really. A Pre-Diabetic has NEVER been diagnosed as a full blown Diabetic. That's the difference between them and you who I presume WAS diagnosed as Diabetic.

cugila said:

....Not really. A Pre-Diabetic has NEVER been diagnosed as a full blown Diabetic. That's the difference between them and you who I presume WAS diagnosed as Diabetic.

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But wouldn't we all react the same to a glucose tolerance test - and wouldn't that show us to be diabetic?

But wouldn't we all react the same to a glucose tolerance test - and wouldn't that show us to be diabetic?

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Not necessarily, and certainly its's not the case for people with impaired glucose tolerance. One study showed of people with IGT at baseline,

30% reverted to normal, 35% remain as IGT, 5% changed to IFG and 30% developed diabetes over the 11-yr follow up period

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and another

people retested after 6 weeks 39% to 46% were reclassified as normal and 6–13% as having diabetes on repeat testing.

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The definition of what is diabetes, and what is IGT/IGF (Its the US that uses the term pre diabetes)is fraught with difficulties, It''s a definition of best fit , they have to use available evidence, which is often contrary and the committee then has to take into account the economic burdens of health care worldwide!

The World health organisation did a review a couple of years ago, they looked at the evidence for the levels used to diagnose diabetes, Igf and Igt.

They used data from retinopathy/glucose levels, there was hardly any valid data available on other complications, and from population studies to define the diabetic cut off line. This was the level that ' there is a significantly increased premature mortality and increased risk of microvascular and cardiovascular complications.' They decided that in spite of poor quality evidence they could keep the present cut off point.
(fasting plasma glucose ≥ 7.0mmol/l (126mg/dl) or 2–h plasma glucose ≥ 11.1mmol/l (200mg/dl))

Having decided that the present level was OK. They looked for a lower level to define normal blood glucose levels, the level at which there was no risk. The data couldn't supply a lower level, many relationships were linear to a low point. They ended up saying '‘normoglycaemia’ should be used for glucose levels associated with low risk of developing diabetes or cardiovascular disease, that is levels below those used to define intermediate hyperglycaemia'

Then they looked again at the IGT and IGF. First, as they weren't able to define a level that was normal, they couldn't define a level where things became 'abnormal' . Not everyone with an impaired glucose tolerance test goes on to develop diabetes or the complications of diabetes.(only 30% in the study mentioned above) There is also some evidence that lifestyle interventions can prevent/delay problems. On the other hand studies showed that the the risk of future diabetes, premature mortality and cardiovascular disease begins to increase at 2–h plasma glucose levels below the present IGT range.
WIth the the impaired fasting glucose limit there was an additional factor to consider because the US had lowered the cut off point from 6.1 to 5.6mmol . Theres too much to go into here but again the evidence isn't clear cut.

At the end the committee decided to keep the levels the same for the moment but they clearly feel that fairly arbitrary cut off figures are not the best method of defining/diagnosiing a person at risk of diabetes and it's complications
they say

'Since the rationale for this category is to define a risk state for future diabete and/or future cardiovascular disease and premature mortality, a risk score combining known risk factors which includes a measure of glucose as a continuous variable, would seem a more logical approach.'

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and they put this in their recommendations for both impaired fasting glucose and impaired glucose tolerance.

'Consideration should be given to replacing this category of intermediate hyperglycaemia by an overall risk assessment for diabetes, cardiovascular disease, or both, which includes a measure of glucose as a continuous variable.'

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In other words, the glucose levels are only one part of the package, no particular level is necessarily
'pre diabetic', nor is any particular level 'safe'.

Phoenix.

Big ((((HUG)))) You took the words right out of my mouth........ :wink:

Ken

That was the summary of the summary

Whatever they decide to call it, we all know that increasing exercise, losing weight, and restricting carbs (in my case via low GL eating) will help prevent whatever we have getting nasty.

Very interesting that Phoenix - Thanks! However, I'm not certain that I've taken it all in on one reading.

I'll try reading it again later after I've had some carbohydrate! :lol:

Best wishes - John