Given the range of difficulties in the criteria for identifying prediabetes, it is not surprising that the populations with prediabetes identified by each method vary widely.
Differences in pre-diabetes glucose screening settings can cause misdiagnosis and this results in some people receiving unnecessary treatment and others being left untreated to prevent or delay the development of overt type 2 diabetes.
Find out in the article on estet-portal.com what effective diagnostic criteria are used and how prediabetes can be prevented in order to reduce the risks of developing overt diabetes mellitus.
Difficulties in diagnosing prediabetes
Prediabetes prevalence estimates reported in the literature vary considerably depending on the diagnostic criteria used for glucose levels, the choice of test method, and the population.
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The blood glucose threshold defined by the ADA guidelines is lower, resulting in a higher prevalence than those defined by the WHO guidelines; in a cohort of 1,547 American adults without diabetes, a change in the lower fasting glucose threshold led to an increase in prevalence from 19.8% to 34.6%.
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A large meta-study of the prevalence of prediabetes in European and Asian cohorts reported that abnormal fasting blood glucose was present in 36% of individuals using WHO guidelines and 53.1% of individuals using ADA guidelines across different blood glucose test reference values .
Alternative methods for measuring glucose levels as a screening method
According to the results of the study, the determination of HbA1c is considered a more reliable method for confirming abnormal glucose levels. A study of more than 1,500 Swiss people who had no health problems found prediabetes in 30.9% of the population; of these, 79.9% were identified based on HbA1c levels, 9.9% − determination of fasting glucose and 10.3% − use of both indicators.
Prediabetes: how to recognize and prevent the threat of diabetes
As you might expect, prevalence estimates vary widely depending on the diagnostic glucose test used, even within the same study population. In some cases, the diagnosis of prediabetes is based on a single criterion (for example, a glucose tolerance test), others evaluate the results of more than one method.
According to the ADA guidelines, an abnormal result on any of the three criteria (fasting blood glucose test, Impaired Glucose Tolerance, or HbA1c test) is sufficient for a diagnosis of prediabetes.
Defining the prevalence of prediabetes in the world
There is a trend towards a global prevalence of prediabetes. When conducting a meta-analysis, it was revealed that impaired glucose tolerance can reach 7.3% in the adult population, which is equal to 352,100,000 people. These study results were published in 2019 in the journal Clinical Diabetes and Endocrinology.
Prevalence is expected to increase to 8.3% of the adult population worldwide by 2045, which is about 587 million people.
There is no significant difference in the prevalence of prediabetes between men and women, and about half of all persons with impaired glucose levels − under the age of 50. Now the highest prevalence rate is noted in the regions of North America and the Caribbean (15.4%), Central and South America (10.0%), and the lowest − in the regions of Southeast Asia (3.0%) and Europe (5.5%).
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Factors influencing the development of prediabetes
A number of epidemiological studies have demonstrated a clear relationship between ethnicity and the likelihood of developing prediabetes. All African Americans, Native Americans, South Asians, and Hispanics have been shown to be at an increased risk of developing prediabetes compared to Caucasians.
The prevalence of prediabetes is influenced by the complex interplay of the following factors: life expectancy, socioeconomic status, material well-being, access to health services, education level, disease propensity/public health initiatives, and the level of obesity in the population. As populations become more urbanized, gain access to better nutrition, health care and education, and life expectancy increases, rates of prediabetes are expected to rise and be more pronounced in developing countries than in developed countries.
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How to avoid the epidemic of prediabetes
The reported prevalence of prediabetes varies widely in the literature, reflecting the heterogeneity of both the methods used to determine the condition and the characteristics of the rates in the populations themselves. A better understanding of prediabetes can help increase early identification, early intervention, such as lifestyle modification with a healthy diet and increased physical activity, and thus reduce the number of people potentially expected to develop diabetes.
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Today, glucose control is a determining factor in the development of prediabetes. Therefore, patients with impaired glucose tolerance, an increase in fasting glucose levels, should systematically undergo a clinical study, the frequency of which depends on the age and weight of the patient.
Prediabetes − a reversible condition, and if lifestyle modification and glucose control is not effective, drugs may be prescribed. However, it is clear that the prevalence of prediabetes is rapidly increasing worldwide and action must be taken to prevent a future epidemic of diabetes.
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