More Rigid Criteria for Prediabetes May Be in Order in the National Diabetes Prevention Program
To delay or prevent type 2 diabetes, the CDC’s
National Diabetes Prevention Program Lifestyle
Change Program (National DPP LCP) treats
individuals with prediabetes. Prediabetes is a
condition where a person's blood glucose is
elevated, but not elevated enough to be called
diabetes. Prediabetes is often a precursor to type
2 diabetes. The prediabetes criteria used by the
National DPP to admit persons into its prevention
program are the same criteria used by the American
Diabetes Association (ADA) and the CDC. However,
those criteria allow individuals into the program
who may be at a very low risk of contracting type
2 diabetes. So, looking at the probability of
contracting diabetes at different points in the
ADA's prediabetes criteria range may be
beneficial. And one study
has done the analysis.
The ADA uses the
following criteria for prediabetes: a
fasting plasma glucose (FPG) greater than or equal
to 100 mg/dL and less than or equal to 125 mg/dL;
an impaired glucose tolerance (IGT) where the
glucose is greater than or equal to 140 mg/dL and
less than or equal to 200 mg/dL; and an HbA1c
greater than or equal to 5.7% and less than or
equal to 6.4%.
The study mentioned above was done in Spain. There
were 1184 participants in the study. And the
participants in the study group satisfied two of
the ADA's prediabetes criteria. These criteria
were FPG between 100 mg/dL and 125 mg/dL and
HbA1c between 5.7% and 6.4%. The mean follow-up
for the group was 4.2 years.
The researchers found that individuals at the
lower ends of the prediabetes criteria ranges had
a lower probability of advancing to type 2
diabetes. Specifically, the researchers stated
that "The
lowest incidence rate of diabetes was
observed in the prediabetes category for isolated
FPG 100–109 mg/dL; and the highest, in individuals
with FPG within 110–125 mg/dL plus HbA1c 6.0–6.4%.
As for reversion to normoglycemia, the highest
rate was in the group with isolated HbA1c
5.7–5.9%, and the lowest in the category with FPG
110–125 mg/dL plus HbA1c 6.0–6.4%."
Therefore, focusing on individuals with prediabetes at the higher levels of blood glucose within the ADA's prediabetes criteria ranges may be a better use of resources.
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posted by Information Uncover at
9:35 AM
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