The number of people with diabetes around the world has quadrupled since the 1980s. Many health care experts believe diabetes is a major public health problem that has reached epidemic proportions. It’s gotten to the point that anyone with elevated blood sugar is being warned that they have a disease called “prediabetes.”
Risk factor, or disease
However such warnings have been attracting a lot of flak lately. The main complaint is that elevated blood sugar used to be considered a modifiable risk factor, not a disease. Some health experts wonder if sowing panic among a populace could be doing more harm than good. Instead of focusing on damning test results, perhaps more could be done to prevent diabetes by promoting a healthy lifestyle changes, such as changing the way you eat and increasing your physical activity.
It’s easy to get diagnosed with prediabetes at the website doihaveprediabetes.org. Answer a few questions about your age, your weight, diet, exercise and blood sugar in the handy online calculator. According to a study published in JAMA Internal Medicine on the prevalence of prediabetes, you have an 80 percent chance of testing positive if you’re over 60 and a 60 percent chance of testing positive if you’re over 40.
However, a study published in the British Medical Journal investigated the accuracy of two common tests for prediabetes: fasting blood glucose and A1C, or glycated hemoglobin. The findings questioned the accuracy of both these tests. According to the authors, the problem with these tests, as well as the results from online calculators, is that a risk factor for prediabetes—high blood sugar—has been “medicalized” to create a new medical condition, as well as new patients.
Alarmed at the results of being medicalized, many people testing positive demand attention from the health care system, incurring drug prescription costs as well as rising insurance costs and problems with employment. According to the Chicago Tribune, the U.S. has the lowest blood sugar threshold for prediabetes in the world. In 2010, the American Diabetes Association moved the prediabetes threshold from 110 to 100 milligrams per deciliter for the fasting blood glucose (finger stick) test.
Research has shown that only 5 to 10 percent of people who receive this prediabetic diagnosis move on to develop full-blown diabetes. About half of those people have normal blood sugar in a follow-up visit. In fact, your blood sugar fluctuates throughout the day and it’s not abnormal to temporarily be within the prediabetes range.
Diabetes is a serious public health issue and a life threatening condition. But if you’ve been medicalized with a prediabetes diagnosis, especially if you’ve received your diagnosis from an online calculator, hold off on the doctor’s appointment and subsequent drug prescriptions. Take a closer look at your lifestyle first.
Perhaps the best thing about prediabetes is that it’s a warning shot, not destiny. You can leave prediabetes in your rear view mirror with lifestyle changes that include eating healthier, exercising more and losing weight. The best part about this prescription is that the first two behaviors lead to the third result.