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 The term prediabetes refers to having elevated blood sugar that does
not reach the threshold for type 2 diabetes, but it is considered a
sign that a person might be headed in that direction. Older age,
obesity and family history increase the risk of prediabetes, which
in turn increases risk for diabetes, heart disease and stroke,
according to the Centers for Disease Control and Prevention (CDC).
Scientific societies need to be careful when they publicly announce
a risk calculator or widget, said lead author of the new study, Dr.
Saeid Shahraz, an investigator in the Predictive Analytics and
Comparative Effectiveness Center at Tufts Medical Center in Boston.
“Our findings show that this risk engine identifies a lot of normal
people as having prediabetes,” Shahraz told Reuters Health.
“Second, even the person who has prediabetes doesn’t necessarily
progress toward diabetes,” he said. “Overall we think this is
putting too much pressure on society of creating or pushing toward
more disease labels for the healthy population.”
The researchers used existing data from the 2013-2014 National
Health and Nutrition Examination Survey of adults aged 18 and older
without diabetes to calculate risk scores for prediabetes based on
seven factors: age, sex, history of gestational diabetes, family
history of diabetes, history of high blood pressure, physical
activity and weight. All factors were worth one risk point except
weight and age, which were worth from one to three points.
About 10,000 respondents who were representative of the U.S.
population were included in the analysis. A total score of five or
more points put an individual at risk for prediabetes.
Based on this scoring system, 73.3 million Americans, or almost 60
percent of the population, are at high risk for prediabetes,
according to the results published in JAMA Internal Medicine. For
those aged 60 and older, 80 percent qualified as high risk for
prediabetes.
For people with prediabetes, physicians emphasize exercise and
maintaining a healthy diet, Shahraz said.
“Healthy diet and physical activity is useful across the board, for
healthy people as well,” he said.
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Shahraz’s team also notes in their report that scoring as “high
risk” for prediabetes with this calculator garners a recommendation
to visit a doctor and get a blood sugar test. If everyone followed
that advice, it could potentially use so many medical resources that
people with actual diabetes or other chronic conditions might not be
able to access the healthcare they need.
“The important thing to focus on is that there’s increasing obesity
which leads to a variety of obesity-related conditions, but labeling
them with these pseudomedical terms like prediabetes isn’t
particularly helpful,” said Dr. Rita F. Redberg, the editor of JAMA
Internal Medicine.
We don’t need to categorize people by diabetes risk to recommend
weight loss, she said in a phone interview.
In an editor’s note accompanying the report, Redberg writes that the
results of this study “elegantly” demonstrate how common conditions
can be “medicalized,” noting that the term prediabetes was “never
heard of 10 years ago.”
“Diabetes prevention programs are essentially weight loss programs,”
she told Reuters Health. “If you’re overweight or obese you should
be working on weight loss.”
If prediabetes could be treated by some specific means other than
lifestyle changes, it may be more worthwhile to label people as
prediabetic, Redberg added.
SOURCE: http://bit.ly/2dqOBpS and http://bit.ly/2cNgyus JAMA
Internal Medicine, online October 3, 2016.
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