A new study in the BMJ reports that the cut-off scores for defining whether someone has prediabetes needs revising.
Prediabetes, a term that is often used interchangeably with metabolic syndromen, exists when a person is diagnosed with high blood sugar levels near-characteristic of type 2 diabetes.
Someone who is diagnosed with prediabetes will also usually have higher than normal blood sugar levels after eating, and/or raised HbA1c levels.
The cut-off points at which a person’s blood sugar is considered abnormal vary across guidelines and countries.
This study suggests that health risks associated with prediabetes seem to increase at the lower cut-off point for blood sugar levels recommended by some guidelines.
The World Health Organisation (WHO) defines prediabetes as fasting glucose levels of 6.1 to 6.9 mmol/L, while NICE defines prediabetes as levels of 5.5 to 6.9 mmol/L.
After conducting a meta-analysis of 53 studies, involving over 1.6 million individuals, researchers from Southern Medical University in China found that risk assessment for prediabetes should be reviewed.
They found that the increased risk of cardiovascular disease and all-cause mortality from prediabetes tend to be higher in people with fasting blood sugar levels as low as 5.6 mmol/L.
This corresponds to the American Diabetes Association (ADA)’s lower cut-off point for impaired fasting blood sugar levels.
Aside from having blood sugar levels regularly tested, the most effective preventative tools in our arsenal against prediabetes remain eating a balanced diet and exercising often.
The new findings highlight that the problem of labelling people as having prediabetes is that these categories are unstable and the risk progression from pre-diabetes to type 2 diabetes differs between populations.
This could therefore have implications for the classification and prevention of prediabetes in the UK.

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