Pre-diabetes vs Diabetes Stage 1: And the Winner Is

Whats In the Name?

When I first read Riva Greenberg’s post “The Lie That’s Killing Us: Pre-diabetes” in Huffpost Healthy Living, I was a bit surprised. According to Ms. Greenberg "Recognizing pre-diabetes as “Stage 1” Type 2 Diabetes will get millions more people to take action to stop their diabetes from progressing.”

Blood Glucose Monitor  

I thought to myself, what difference will it make if you call it “pre-diabetes” or “diabetes Stage 1”? Clearly, the name changes nothing about your status as a pre diabetic.

As I read on, I kept wondering how it is going to encourage “the nearly 80 million Americans” to do something about their “diabetes stage 1” that they are not doing for their “pre diabetes”? Are they really going to make the lifestyle changes necessary to prevent advanced Type 2 diabetes?”

I totally agree with Ms. Greenberg that we need new strategy. The American Diabetes Association (ADA) may have failed with its campaign to encourage pre diabetics to participate in preventive and healthy behavior, but it has nothing to do with what we are calling this dreadful condition.

Is Pre-diabetes A Lie?

I don’t think that calling it “diabetes stage 1” is going to impress anyone more than calling it “pre-diabetes”. I also don’t think it will frighten someone out of their wits and push them to make the changes necessary to stop the development diabetes Type 2.

One of the things that the ADA did accomplish is raise the awareness to Pre diabetes. When my doctor diagnosed me with pre diabetes 7 years ago it was called Borderline Diabetes. There are other names such as Impaired Fasting Glucose and Impaired Glucose Tolerance. There is no shortage of labels. Adding one more would only add to the confusion.

Is changing the name pre diabetes to diabetes Stage 1 going to help the 8 million Americans who already have diabetes in various stages and aren't even aware of it? “About two thirds of the persons with undiagnosed diabetes have already seen a doctor two or more times in the past year, according to the researchers.” I don’t think so.

Should We Make Diabetes Sound Like Cancer?

Pre diabetes may be diabetes Stage 1. However, it is not the same as Stages 2 - 4. Stage 1 is the stage where “with proper treatment, a person may go into remission or be able to prevent or delay moving to Stage 2.”

We have two major organizations who haven’t even agreed on the criteria for pre diabetes. The World Health Organization (WHO) opted to keep its upper limit of normal under 110 mg/dL, even though fasting plasma glucose levels 100 mg/dL and higher have been shown to increase complication rates significantly.

The ADA, on the other hand, lowered the upper limit of normal fasting plasma glucose under 100 mg/dL. This means that according to WHO, you are pre diabetic only when your blood sugar level is above 110 mg/dL. The ADA says you have pre diabetes when your blood sugar level is above 100mg/dL.

A suggested approach to inspire and stimulate pre diabetics to take advantage of this window of opportunity to reverse pre diabetes, or as I like to call it, “kiss pre diabetes goodbye” is to amplify the consequences of not taking action.

Are We Seeking to Present Diabetes to Sound Worse?

According to the ADA, diabetes is the leading cause of heart disease, stroke, kidney disease, blindness, and amputation. Since 1987, death rates due to diabetes have continued to rise, while the death rates due to heart disease, stroke, and cancer have declined.

Diabetes is associated with an increased risk for a number of serious, sometimes life threatening complications, which include:

  • Heart Disease and Stroke Adults with diabetes have heart disease death rates 2 to 4 times higher than adults without diabetes.

  • Blindness

  • Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year making diabetes the leading cause of new cases of blindness in adults 20 - 74.

  • Kidney disease

  • Diabetes is the leading cause of kidney failure

  • Amputations

  • More than 60% of non traumatic lower limb amputations occur in people with diabetes.

The statistics clearly point to the fact that diabetes is becoming a monster with many heads, and we are not taking it seriously. I would like to be as optimistic (or naive) as Riva Greenberg and believe that changing pre diabetes to Diabetes Stage 1 is going to cause a few million Americans to do something about their pre diabetes.


“The Lie That’s Killing Us: Pre-diabetes”


American Diabetes Association


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