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Prediabetes Findings May Be False Hope

Patient with diabetes.

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Key Takeaways

  • Data from the U.K. suggests that fewer people with prediabetes developed type 2 diabetes between 2010 and 2015 than in the five years prior.
  • This decrease may be attributed to a lower threshold needed for a prediabetes diagnosis, instead of an actual decrease in the number of people diagnosed.
  • Moderate exercise and dietary changes can reduce the risk of progression from prediabetes to type 2 diabetes.

A new study from the United Kingdom found that between 2010 and 2015, fewer individuals diagnosed with prediabetes went on to develop type 2 diabetes than in the five years prior. While this may sound promising, these findings may not actually mean that fewer people are developing diabetes. Instead, experts say it could just be a reflection of changing criteria needed for a prediabetes diagnosis. 

The study, published on September 6 in the British Medical Journal, evaluated the number of prediabetes patients developing type 2 diabetes from 2000 to 2015. Researchers found that annually, 7% of prediabetes patients went on to develop type 2 diabetes.

From 2010 to 2015, researchers noticed a reduction in the number of people with prediabetes developing type 2 diabetes.

“This reduced conversion from NDH [non-diabetic hyperglycemia, or prediabetes] to type 2 diabetes appears to be more indicative of a lower threshold for NDH diagnosis criteria and more people of lower diabetes risk being diagnosed, rather than an increased rate of diet and lifestyle changes reducing conversion to type 2 diabetes,” Dione Milauskas, MS, RDN, LD, a registered dietitian in Kentucky specializing in prediabetes nutrition, tells Verywell.

What This Means For You

If you are diagnosed with prediabetes, you can reduce your risk of developing type 2 diabetes by making certain lifestyle changes, like changing your diet or incorporating exercise in your daily routine.

Limitations of The Study

Hailey Crean, MS, RDN, CDCES, a registered dietitian specializing in diabetes care in Massachusetts, echos Milauskas concern, telling Verywell that the researches of this study "encourage examination of the study limitations, which include a change to the coding practices used to report cases, as well as a change to the definition of prediabetes, during the study period."

Crean notes that the criteria for prediabetes vary slightly between the U.K. and the U.S., with a 6% to 6.4% hemoglobin A1C—a measurement of average blood sugar level for the past three months—needed for a diagnosis in the U.K.

In general, U.S. criteria includes:

  • An A1C level below 5.7% is considered normal
  • An A1C level between 5.7% and 6.4% is considered prediabetes
  • An A1C level of 6.5% or higher on two separate tests indicates type 2 diabetes

What is Prediabetes?

Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), approximately 88 million American adults have prediabetes. A prediabetes diagnosis can serve as a warning sign that your body may be heading toward a type 2 diabetes diagnosis unless you make lifestyle changes.

From this data, it is unclear whether the reduced rate of diabetes diagnosis is due to changes in screening criteria or a result of a true reduction in the progression of prediabetes. While we know that the U.K. modified their criteria for diagnosis during the study, Crean also points out that the work done by primary care providers in the U.K. in recommending lifestyle changes to prediabetes patients is cited by researchers as a possible contributor to the results. 

“Prediabetes can be managed easily with diet and lifestyle changes and without medication or weight loss," Milauskas says. 

The Benefit of a Prediabetes Diagnosis

Having a reduced rate of prediabetes patients developing type 2 diabetes is only meaningful if individuals are actually making lifestyle changes to prevent the progression of the disease.

“From a population health perspective, increased diagnosis can be beneficial," Milauskas says. "If diagnosed at the NDH (prediabetes) level of impaired glucose metabolism, diet and lifestyle changes can be made earlier on, delaying or preventing a conversion to type 2 diabetes." She adds that it is easier to lower blood glucose at the prediabetes level than at the type 2 diabetes level.

Researchers also found that certain factors increased the risk of developing type 2 diabetes, including:

  • Being in the age range of 45-54 years
  • Smoking
  • Struggling with depression 
  •  Having a high BMI
  •  Living in a more deprived area 

If you've been diagnosed with prediabetes, the good news is that there are steps you can take to help reduce the risk of developing type 2 diabetes. 

Milauskas suggests that those with prediabetes can focus on adding more protein and healthy fat to their diet, walking five days per week, and managing stress. She says that walking for 30 minutes per day reduces conversion from prediabetes to type 2 diabetes by 30%.

“Even just a few small changes has the ability to put someone on the path to better blood glucose control,” Holly Falke, MS, RDN, LD, CDCES, a registered dietitian in Texas and certified diabetes care and education specialist, tells Verywell. She adds that choosing foods that are higher in fiber, such as vegetables, fruits, and whole grains is a positive change that people can make to help reduce the risk of developing type 2 diabetes. 

Making Lifestyle Changes With a Prediabetes Diagnosis

Learning that you have prediabetes can be a motivator to make some lifestyle changes to reverse the diagnosis and reduce the risk of developing type 2 diabetes. 

The Diabetes Prevention Program highlights the power of lifestyle changes in the progression of the disease. They found that attaining a 5% to 7% weight loss goal and engaging in 150 minutes of moderate-intensity physical activity per week lowered the risk of progression to type 2 diabetes by 58%. So, if you are diagnosed with prediabetes, now is the time to brush off your walking shoes and get your body moving—it may help keep your health in check in a simple and low-risk way. 

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