Medical Experts Disagree on Prediabetes Overdiagnosis and Screening Methods

Prediabetes might be over diagnosed, and experts disagree over how and when to screen for this disease. They also argue that prediabetes is diagnosed too quickly sometimes and that can cause more harm than good. It is stressful when a medical professional tells a person they have prediabetes. Some doctors said the diagnosis can cause people to go through unnecessary medical visits and laboratory tests. This can lead to additional costs, such as deductibles and copayments. 

Pre-diabetes can signal the initial stages of metabolic syndrome, which increases the risk of cardiovascular disease, some common cancers, and neurocognitive disorders. Type 2 diabetes is a preventable disease, but researchers don’t agree on who is at high risk and who is a good candidate for preventive intervention. 

Prediabetes is not an emergency but an opportunity to assess and minimize long-term risks. Before jumping into treatment, it is advisable to ensure that the individual is at increased risk by reviewing other indicators of metabolic health. Prediabetes should be addressed primarily through lifestyle modifications, focusing on improving nutrition, physical activity, and sleep patterns. Treatment is personalized and if lifestyle changes are insufficient or challenging to implement, identifying underlying barriers becomes crucial. In such cases, medications may be considered as part of a comprehensive plan to manage or reverse prediabetes or help overcome its barriers. Understanding an individual’s lifestyle and root causes is key to effective treatment.  

Other experts say more concrete definitions as well as the ability to tailor treatment to an individual are needed. The author raises a very important topic regarding the diagnosis of dysglycemia by current standards and the poor correlation between the definitions. When applying findings of population-based studies to clinical practice, it is important to always take into consideration other factors that could be contributing to the specific test outcome or to the patient’s situation. 

In March 2024, the Food and Drug Administration allowed marketing to begin on an over-the-counter continuous glucose monitor which previously was only available via a prescription to help people with diabetes track glucose levels. People sometimes scare themselves because they use these machines without understanding how to use them or how to interpret the results. They may not understand that exercise or a hot shower can raise their A1C. They see elevated numbers and panic. People need to be very careful when using these without coordination with their doctor. Prediabetes is when blood glucose levels are higher than normal, but not yet high enough to be in the diabetic range, according to the American Diabetes Association. 

Since type 2 diabetes develops over time, many people with prediabetes are at risk of developing diabetes. However, not everyone with prediabetes will advance to diabetes, particularly with lifestyle interventions. Because there are no clearly defined symptoms of prediabetes, people find out when they have routine blood tests that include checks for their blood glucose levels.