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  • Cameron Oglesby

How worried should you be about prediabetes? (Less than you might think)

Updated: Nov 12, 2021

Tens of millions of Americans have been diagnosed with a condition that’s painless, has no symptoms, and is detectable only from blood-test results The condition is prediabetes, and it often comes hand-in-hand with later life, when the pancreas starts cutting down its insulin output.

If you have more than normal glucose in your blood – 5.7% to 6.4% hemoglobin A1C or 100 to 125 mg/dL fasting glucose level – you’ve got it. In theory, as the name implies, it’s just one step away from type 2 diabetes, which can play havoc with your health. Diabetes “damages your kidneys, your eyes, and your nerves,” says geriatrician Dr. Kenneth Lam. ”It causes heart attack and stroke.”

But a study published online in JAMA Internal Medicine this year showed that older people who met those prediabetes criteria were much more likely to return to normal blood sugar levels than to graduate to full-blown diabetes.

Over a five- to six-year period, only 9% of the study’s older participants had developed diabetes, while 13% to 44% saw their A1C and fasting glucose levels drop back to normal. Leading the study’s senior author, Dr. Elizabeth Selvin of the Johns Hopkins Bloomberg School of Public Health to conclude, “In most older adults, prediabetes probably shouldn’t be a priority.”

Insofar as a treatment for prediabetes exists, it consists of healthy eating, losing weight, exercising and cutting out smoking – all good things to be doing anyhow.

But many physicians, including Dr. Selvin, Dr. Lam, and his colleague, Dr. Sei Lee, feel uncomfortable about “medicalizing” a condition where, Dr. Selvin says, “we’re not seeing much risk.”

“It’s unprofessional to mislead people, to motivate them by fear of something that’s not true,” Drs. Lam and Lee wrote.

Dr. Selvin believes that overemphasis on prediabetic blood sugar can divert attention away from “complex health issues” that “older adults can have. Those that impair quality of life should be the focus, not mildly elevated blood glucose.”

Dr. Lee, who’s one of the study’s co-authors, and Dr. Lam both argue that the best way to treat prediabetes in older adults is on a case-by-case basis.

When you consider that no two seniors have identical physical conditions, life histories, habits and interests (among other things), working case by case is also the best way to approach caregiving.

That’s why working case by case, person by person, has been our core value and our priority ever since Senior Insights first opened its doors. We’ve always believed that caregiving has to go beyond physical needs and tasks, to address each client’s unique, individual emotional, cognitive, psychosocial and environmental needs as well.

If you’d like to learn what a difference our holistic approach can make, please click here to contact us.

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