Researchers say aggressively treating pre-diabetes could stop or delay future diabetic complications

Treating pre-diabetes as if it is diabetes could delay or prevent future related health complications, according to doctors from three leading research institutions and the American Diabetes Association, says a press release from the University of North Carolina School of Medicine.

The researchers writes in the journal Diabetes Care that “by not devising a treatment strategy for people with pre-diabetes, doctors run the risk of creating a pool of future patients with high blood sugar who then become more likely to develop serious complications, such as kidney disease, blindness, amputations, and heart disease.”

Type 2 diabetes is diagnosed with a fasting blood sugar of 126 or higher; most of these patients are treated with medication. Prediabetes is diagnosed with sugar levels between 100 and 125, and the release says such patients are usually not treated aggressively.

“Diabetes is generally diagnosed and first treated about 10 years later than it could be. We waste this critical opportunity to slow disease progression and the development of complications,” lead author Lawrence Phillips of Emory University said in the release.

Kentucky ranks 17th in diabetes, according to the 2014 “State of Obesity” report. The report projects that there will be an increase of 51 percent of people with diabetes in Kentucky by 2030, going from 394,029 people with diabetes in 2010 (or 10.6 percent) to 594,058. The Kentucky Cabinet for Health and Family Services reports an estimated 233,000 adult Kentuckians have pre-diabetes.

“We need to screen and track patients with pre-diabetes to manage their blood sugar more aggressively,” John Buse, professor of medicine and director of the UNC Diabetes Care Center, said in the release. “We’re very confident this would spare our patients serious health issues down the road.”

Evidence for this study comes from clinical trials where “lifestyle changes and/or glucose-lowering medications decreased the progression of pre-diabetes to Type 2 diabetes,” says the release. The future development of diabetes also remained less in those who implemented these changes and then withdrew from them compared to a pre-diabetic control group who did not get any interventions.

Patients who achieved a normal glucose level, even for a short time during the trials, showed a “substantial reduction in subsequent development of Type 2 diabetes,” says the release.

The authors say in the release that based on this evidence diabetes management should change to include regular screening in adults for pre-diabetes and early Type 2 diabetes and if a patient has either one of these conditions and is determined to benefit from treatment, they should get “management that will keep their blood glucose levels as close to normal as possible.”

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