TELLING people they have borderline diabetes has no medical value, researchers say.
EXPERTS from University College London (UCL) and the Mayo Clinic in Minnesota in the US have said that giving people the pre-diabetes label has no clinical worth.
Their analysis, published in The British Medical Journal (The BMJ), states that current definitions for pre-diabetes, an umbrella term most commonly used to describe people with moderately high blood sugar, risk “unnecessary” medicalisation and create “unsustainable burdens” for healthcare systems. Treatments to reduce blood sugar only delayed the onset of type 2 diabetes by a few years, and the authors found no evidence of long-term health benefits, a UCL spokesman said. “Pre-diabetes is an artificial category with virtually zero clinical relevance,” says lead author John Yudkin, Emeritus Professor of medicine at UCL. “There is no proven benefit of giving diabetes treatment drugs to people in this category before they develop diabetes, particularly since many of them would not go on to develop diabetes anyway. “Sensibly, the World Health Organisation, the National Institute for Health and Care Excellence and the International Diabetes Federation do not recognise pre-diabetes at present, but I am concerned about the rising influence of the term. It has been used in many scientific papers across the world, and has been applied to a third of adults in the UK and half of those in China. “We need to stop looking at this as a clinical problem with pharmaceutical solutions and focus on improving public health. The whole population would benefit from a more healthy diet and more physical activity, so it makes no sense to single out so many people and tell them that they have a disease.” Barbara Young, chief executive of charity Diabetes UK, said being identified as pre-diabetes allowed people to focus on health living. “Being identified as having pre-diabetes, borderline diabetes or being at high risk provides an opportunity for those people who have a major chance of developing Type 2 diabetes, a lifelong condition which is associated with extremely serious complications such as blindness and stroke, to walk away from it. “Knowing that up to 18 million people in the UK potentially fall into the category of having pre-diabetes highlights the need for public health interventions in order to avoid a dramatic increase in Type 2 diabetes in the future. The focus here really needs to be on how to inform people about their risk of Type 2 diabetes, how to get them engaged and motivated to make changes and how to provide them with the necessary support to do so. Currently, this isn’t happening. “Eating a healthy balanced diet, low in salt, sugar and fat and rich in fruit and vegetables, as well as being physically active is the best way of reducing the risk of developing Type 2 diabetes.”