Pre-diabetes label ’unhelpful and unnecessary’

Labelling people with moderately high blood sugar as pre-diabetic is a drastically premature measure with no medical value and huge financial and social costs, say researchers from UCL and the Mayo Clinic, Minnesota. The analysis, published in the BMJ, considered whether a diagnosis of pre-diabetes carried any health benefits such as improved diabetes prevention. The authors showed that treatments to reduce blood sugar only delayed the onset of type 2 diabetes by a few years, and found no evidence of long-term health benefits. Type 2 diabetes is typically diagnosed with a blood test that measures levels of haemoglobin A1c, which indicates average blood sugar level over the last three months. People with an A1c over 6.5% can be diagnosed with diabetes but the latest guidelines from the American Diabetes Association (ADA) define anyone with an A1c between 5.7% and 6.4% as having pre-diabetes. If the ADA guidelines were adopted worldwide, a third of the UK adult population and more than half of adults in China would be diagnosed with pre-diabetes. The latest study questions the logic of putting a label on such huge sections of the population, as it could create significant burdens on healthcare systems without conferring any health benefits.
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