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What's the point of the 'prediabetes' diagnosis?

Hedonista

Well-Known Member
Messages
240
Type of diabetes
Prediabetes
Treatment type
Diet only
Apologies if this is a ridiculous question, but what's the point of the prediabetes diagnosis?

I was diagnosed as prediabetic at the beginning of this year, and thought 'that's a stroke of luck, caught it before I was actually diabetic' - but now I'm wondering what's the difference? Like most people with Type2, I must change my diet forever, lose weight, exercise more and abandon the idea that I can eat chips on holiday or whatever. How is what I'm doing any different from if I'd been diagnosed Type2, except that I have to pay for my testing strips?!!

This isn't meant to be flippant, or disrespectful of people diagnosed with Type2, but the prediabetic label is making no sense to me...
 
In some respects it's a very silly diagnoses you either is or you isn't, bit like saying your pre-pregnant ( you either is or you isn't pregnant).
Then again though you have been given a warning to sort yourself out before any damage is done long-term. With some people this is all that's needed (proactive) Others will ignore the problem though so the GP has the diagnoses flagged up so he can then try and help the person who doesn't want to be helped or has ignored the warning.
 
I spent about 10 months being knowingly prediabetic so I think I can comment on this.

I think one of the key differences between pre-D and (T2)D is that you don't have to restrict your food as much as we do, potentially. You have more of a buffer between your current state and the risk of complications. You (and we) can still eat chips on holiday (IMO. I believe in occasional treats for the maintenance of sanity).

Think of pre-D as an early warning and a chance to stop it getting worse. I didn't and I wish I had. It would have been easier than clawing all the way back from the higher HbA1c level that I had at my T2 diagnosis.

Many (most?) T2 diabetics in the UK also have to pay for their own testing strips, btw. In another thread I'm comparing test strip prices to show that if you buy the cheapest strips, it's a relatively inexpensive way to improve your health. I have numerous ongoing medical conditions that each cost me a little bit to manage. There's no such thing as a free lunch I'm afraid.

It's possible that if you stay pre-D, or lower in HbA1c terms, your overall costs will end up lower than if you were T2. We only need enough test strips to show us what to eat and to check we are lowering our BGs and keeping them low, (and perhaps to check for the occasional hypo, depending on our situation). This doesn't mean testing 8 times a day for the rest of our lives.

I think an optimal way to approach a diagnosis of pre-D is "Phew, that was a lucky escape, now I don't have as big a job getting healthy as if I'd only been diagnosed once I got to the T2 stage". If that makes sense. Better to find out now than later.
 
Well I wish I had known earlier. Then I may have been able to lose weight earlier once I knew that carbs, not calories were the problem.
 
I do share the sentiment and see your point, @Hedonista, but as noted above, it's an early warning and a buffer. The measures you need to take to avoid T2 are easier than the measures you would need to adopt to manage it if it developed into T2.
 

Hedonista - The diagnosis may motivate some to make a difference, like you, but for others, they'll see it as a big "so what", and carry on as before.

But, as you probably know, a diagnosis of T2 isn't a path to NHS sponsored test strips for most people.

Personally, I would like to have known if I were shown to be pre-diabetic, but I honestly can't be certain how I would have dealt with that label.
 
I was diagnosed as pre-diabetic last October and it scared the you-know-what out of me. This was mainly because my mother suffered an amputation (she was not diabetic), so I knew first-hand how traumatic this is.

I am now pleased that my pre-d was picked up. It gave me the incentive to loose the two stones which had crept on over the years . My original HbA1c was 44, down to 43 three months later and now at 38 which I am very pleased with.

So, I figure it's better to know which way you're heading and do something constructive to head it off.

And, because of the massive weightloss (now weighing in at 7st 13lbs.), I have had to buy a whole new wardrobe. **** shame!
 
Well I realized that I was pre-diabetic by reading about syndrome X. I tried to do something about it, but it would have been really helpful if I had had medical support back then and it would have saved me such a lot of wasted research before I found the answer.
 
I wish I had the luxury of a pre-diabetes diagnosis. I kept reporting the 5 major symptoms of diabetes for 6 months to my GP and he put it down to meds I take. Well my OGTT was off the chart. I now take insulin and wish I had been monitored more closely by my doctor.
 
Thanks for your responses. I think what I'm trying to say, is that as far as I understand it, I will never be able to eat the level of sugar and carbs that non-prediabetic people eat, and that if I did, I'd sooner or later attain the levels that trigger a diagnosis of Type 2. So I feel that it's a bit of an arbitrary line, that makes little sense. I'm 'pre' diabetic because my BG was 46, not 48, but why is the 47 number so significant? Even if I get my BG down into the 30s as I'd like, I'll still have to eat with care to avoid high BG, just as someone whose HBa1c was 48+ would have to. Do you see what I mean? It's not like a warning that gives me a chance to repair things and go back to normal!

Point taken about paying for strips though!
 
Also from a different perspective- health insurance, life insurance, travel insurance can increase by quite a bit. We thought about remortgaging a couple of years ago and my life insurance for the loan was nearly twice my hubby's and he has epilepsy - they said it didn't matter how good a diabetic I was - I was T2 and my life expectancy was lower full stop!
 
I was diagnosed with hypothyroid in October 2013 and was tested for diabetes too and the diabetes test came back normal.

In January 2014 my dentist said I have definitely got diabetes. I told him I couldn't have as I was tested a few months ago.

In July 2014 I again was tested for diabetes and again the test came back normal.

Then in October 2014 I started getting diabetes symptoms and I was then diagnosed as full blown type 2 diabetic.

I didn't even get to the pre-diabetic stage. I missed it!!

You are very lucky that you can turn things around as this is your warning to change - I didn't get this chance!!

My father is lucky he is at the pre-diabetes stage and is changing his lifestyle and diet for the better - hopefully he is doing enough to keep diabetes at bay
 
I think the pre-diabetic label is indeed somewhat arbitrary. My understanding is that the diagnoses for diabetes was set at a level where 'they' thought complications could set in. My thoughts are that if you are diagnosed as pre-diabetic then it does mean that you have something wrong and cannot deal with carbs the way a 'normal' person would. Unless lifestyle changes are made then it is almost definitely going to continue until you reach 'diabetic' levels. The benefit for anyone diagnosed as pre-diabetic is that you can make these adjustments earlier and hopefully well before any complications set in.
However I don't think enough is made of the 'pre-diabetic' diagnoses and nor is the advice given any good at all. I was just told to go away and eat more starchy carbs with every meal - absolutely the wrong advice and pretty much guaranteed to ensure decline into diabetic levels sooner rather than later. I think myself lucky that I actually ignored that advice to start with (basically in denial I guess). I was told to come back the following year but it was only on then being 'threatened' with medication including statins that I woke up to the fact I needed to do something - and that that something was not to follow NHS advice.
If the NHS actually gave good advice - in particular the beneficial effects of a low carb high fat diet and much more exercise - to everyone diagnosed as 'pre-diabetic' then I believe they could pretty much stop Type 2 diabetes in it's tracks.
Do they prescribe plenty of gluten to coeliacs or plenty of alcohol to alcoholics or plenty of protein to those with kidney disease. No, so why do they persist in suggesting plenty of carbs to those whose bodies patently have an inability to deal with carbs. Madness and the sooner NHS wake up to the fact the better.
 
I think it's a silly term just as I believe saying you have 'mild diabetes or whatever is a valid term. Diabetes is complete spectrum from very low HBa1C right thru the range. What is useful to know is where you are on the spectrum compared with the population at large and therefore whether you need to take action.
 

Diabell is right to use the word spectrum. They draw the line at 47 only because they have to draw it somewhere. The other day I suggested to someone whose HbA1c was 36 that they might want to reduce their carbs and get it tested annually to make sure they don't become prediabetic. Regardless of HbA1c, everyone should be sensible about sugar and carbs... our bodies have not evolved fast enough to adapt to a moderate or high carb diet. People further along the spectrum than 42 just have bodies that find carbs a bit harder to deal with.

I've learned that it's usually not helpful to use the word "never". You (and I) can enjoy occasional sugary and carby food, as long as it's occasional, without doing long term damage. A person with HbA1c in the 30s does not have to eat with the same care as someone 48+ does. Prediabetes is a warning that gives you a chance to repair things and go back to almost normal.
 

The earlier you are diagnosed, the better chance you have of avoiding complications.
And it depends on why you are becoming diabetic.
I firmly hold to the idea my diabetes was the result of my very poor junk food diet making me obese.

Change the diet, and you may improve your condition to the result that you never become diabetic ie, cross the line into higher BG readings.

As to a permanent change of diet, yes, you need to accept that.
But, looking back, I don't especially want to go back to the excessive food consumption that got me overweight, as when I lost the weight, I lost the 'diabetes'
But, I still want the odd thing that I like instead, and still do.
I eat healthy, but I'm not obsessed by what I eat, or what my BG is now, as I'm much healthier overall.
 
Thank you all for your thoughts on this. I too wonder about arbitrary numbers but I can see how they may have to be introduced. However, I'm saddened by the depth of denial among people I know to be diabetic (including my brother) and also on the Desmond course I attended. For such people a diagnosis of prediabetes may be simply a licence to carry on as usual.
This forum is an oasis in the desert.
 

That's always going to be human nature though.
 
I see a lot of people talking about a hba1c.

Just a point that I think is relevant and I'll use myself as an example.

On diagnosis my hba1c was 88 and I was diagnosed with type 2 diabetes.

In 6 months I reduced my hba1c to 35 - to some people, they suggest to me that I am not a diabetic. I have to then explain that I have excellent control of my diabetes and I will always be a diabetic even though my hba1c is 35 at the moment.

As we all know this can change.

My belief is if your hba1c is slightly raised and you are told you are pre-diabetic and you can reduce your hba1c to 35 then you could be considered as a non-diabetic.

Does this make sense to anyone?
 
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