Science & Technology, New Zealand (Commonwealth Union) – Prediabetes is a condition in which blood sugar levels are higher than normal, however it isn’t enough to be diagnosed as type 2 diabetes. People with prediabetes have blood sugar levels that are above the normal range, but not high enough to be classified as diabetes. Prediabetes is also known as impaired glucose tolerance or impaired fasting glucose. Having prediabetes means that there is an increased risk of developing type 2 diabetes, as well as other serious health problems such as heart disease and stroke. However, with lifestyle changes such as weight loss, healthy eating, and regular physical activity, it is possible to prevent or delay the onset of type 2 diabetes and improve overall health.
University of Otago scientists have shown that enhanced targeting is required for screening and treatment of prediabetes which can help in reducing the risk of type 2 diabetes to lower the burden on health sector resources.
An article appearing in the Journal of Primary Health Care, the scientists pointed out that New Zealand’s ‘one-size-fits-all’ approach to prediabetes has no reflection on the variable rate at which various groups end up with type 2 diabetes.
Lead author Dr Christine Barthow, from the University of Otago, Department of Medicine, stated that prediabetes affects 21% to 26% of adults and Māori and Pacific populations are overly represented within the group.
“Despite the large number of people affected, the associated health risks from prediabetes are multifaceted, highly variable and not fully understood for New Zealand populations.”
Roughly 5% of adults having prediabetes will end up with type 2 diabetes over a 3-year period. Men, younger people and those with higher blood glucose and BMI (Body mass index) levels have a higher risk of their condition going further. Those 35–44 years old are 3 times more likely to develop type 2 diabetes than those more than 65 years old, as indicated by researchers.
The country’s guidelines for prediabetes has recommendations for healthcare providers to give lifestyle modification advice, consider the prescription of metformin to lower blood glucose levels and actively handle cardiovascular disease risks.
Dr Barthow indicated that while the identification of prediabetes gives an early chance to take action in blocking or delaying the onset of type 2 diabetes, present guidelines and the funding models for primary care do not to take into consideration the increased risk faced by certain population groups.
“Our current approach creates an unnecessary burden on the primary health care sector for too little gain. Māori and Pacific peoples are particularly poorly served and yet have high health needs in this area.”
Dr Barthow further stated that healthcare providers may face issues when attempting identify which patients have an increased chance of progressing to type 2 diabetes and are sometimes not sure about when exactly intervening is necessary.
She indicated that adults get generally noted with prediabetes as a component of the cardiovascular risk assessment screening provided to elderly groups, however this approach risks not identifying individuals having an increased risk, such as those in younger age groups, having an increased chance of taking advantages from the interventions.
The authors stated that the present guidelines have to be reviewed and updated to be on par with the most recent evidence in regards to those at increased risk of developing type 2 diabetes. They recommend drawing attention to the risks younger people face; targeting interventions to groups with increased risks, further including guidelines for prescribing metformin.
They further recommended the formation of New Zealand-specific risk assessment tools to find out who must be prioritized for prediabetes and diabetes screening and which groups would have an increased advantage from higher intensive diabetes prevention support making sure limited health care resources are provided to those who most require it.
