The Grapevine

Prediabetes Defined: Why Slightly Elevated Glucose Levels Shouldn’t Be Considered Alarming

Amid the global war on diabetes, the scientific community is also battling “prediabetes.” But it is not the disease that causes the problem, it’s the use of the term that has sparked concerns for millions of people across the world. 

In a report published Friday in the journal Science, author Charles Piller said prediabetes is a word that should not exist. It was coined by the American Diabetes Association (ADA) and other diabetes-related institutions to define the condition of patients with above-normal levels of glucose. 

Piller, along with other health experts, said prediabetes is not an actual disease or complication and that sudden elevated glucose levels does not always indicate the development of diabetes in the future. The medical community raised concerns with ADA’s use of the term as it already created millions of new “patients” who are actually healthy. 

In addition, Piller said the pharmaceutical industry has been taking advantage of the issue. Some companies have been already promoting treatments despite the lack of scientific evidence linking prediabetes to diabetes. 

The use of the term also led ADA to lower the conditions required to be diagnosed as prediabetic, a move that made more people, even healthy ones, “at risk” for the condition. The Centers for Disease Control and Prevention (CDC) also adopted the term and has been using it as a warning marker for people with elevated glucose levels. 

These changes led some doctors to begin prescribing medications to patients diagnosed as prediabetic. 

The impact on people

Piller said misdiagnosis has been pushing many people to unnecessarily spend money to treat prediabetes. He said the coinage of the term has led to negative consequences affecting the public, such as financial losses due to having to pay for care as well as unnecessary anxiety.

“The push to diagnose and treat prediabetes has come at a cost. When told they have the condition, many people face psychological and financial burdens trying to address it,” the author said. 

Prediabetes deniers

Despite the growing number of health experts and institutions joining the prediabetes bandwagon, there are some organizations opposing its use to diagnose patients or predict the development of diabetes.

The World Health Organization (WHO), among other institutions around the world, has rejected it as a diagnosis. 

In 2018, researchers found in a review of 103 studies that most people who qualify as prediabetic never progressed to diabetes. Those who developed diabetes actually had higher signs than the ADA prediabetes test range.

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