Prediabetes

What Is Prediabetes?

Prediabetes is a label created by the American Diabetes Association to describe blood sugar levels that are higher than typical but not high enough to be diagnosed as diabetes. It is important to know the truth: “prediabetes” is simply a variation in blood sugar levels that may or may not progress to diabetes. There are a number of ways to manage it that don’t include weight loss.

The main symptoms include:

  • Often there are no symptoms at all
  • Some people may experience fatigue
  • Your doctor might discover it during routine blood work

The Truth About Prediabetes and Weight Loss

Unlike most medical conditions, prediabetes wasn’t discovered through scientific research – it was created by the American Diabetes Association (ADA) in 2001. Here’s what happened:

  • The ADA, which receives substantial funding from pharmaceutical companies, decided to focus on the upper end of normal blood sugar levels
  • They created the term “prediabetes” and began recommending medications for it
  • In 2009, international diabetes organizations rejected the term as not scientifically sound
  • Despite this rejection, the ADA continued expanding the definition to include more people
  • The World Health Organization and most countries outside the US don’t recognize these expanded definitions
  • By 2012, this created condition was costing the US healthcare system $44 billion annually

What Influences Blood Sugar Levels?

Unlike most medical conditions, prediabetes wasn’t discovered through scientific research – it was created by the American Diabetes Association (ADA) in 2001. Here’s what happened:

  • The ADA, which receives substantial funding from pharmaceutical companies, decided to focus on the upper end of normal blood sugar levels
  • They created the term “prediabetes” and began recommending medications for it
  • In 2009, international diabetes organizations rejected the term as not scientifically sound
  • Despite this rejection, the ADA continued expanding the definition to include more people
  • The World Health Organization and most countries outside the US don’t recognize these expanded definitions
  • By 2012, this created condition was costing the US healthcare system $44 billion annually

Prediabetes Without Weight Loss

Contrary to popular belief, evidence for weight loss as a prediabetes treatment is weak:

  • Long-term studies show no clear link between weight loss and diabetes prevention
  • Weight cycling can increase diabetes risk by up to 33%
  • Very low-calorie diets prove ineffective
  • Stress from weight loss attempts may worsen blood sugar regulation

How Weight Stigma Affects Your Care

Weight stigma in healthcare can have serious consequences for people labeled with prediabetes:

  • Unnecessary focus on weight loss can lead to medical avoidance in the future
  • Weight loss attempts may lead to diabates
  • You might be pressured into harmful restrictive diets 
  • The stress of forced weight loss attempts could worsen metabolic health

Alternatives to Weight Loss: Your Rights as a Patient

You deserve healthcare that:

  • Considers all available treatment options including the option to do nothing
  • Focuses on your symptoms as opposed to just the numbers on the screen
  • Doesn’t worsen your health by focusing on weight loss
  • Respects you and takes your concerns seriously

Advocating For Treatment Without Weight Loss

If your doctor is only focusing on weight loss:

  • Remind them that up to 60% of prediabetes cases resolve on their own without intervention

Effective Communication Script

“I have researched the benefits and risks of intentional weight loss for prediabetes. I do not wish to pursue this approach and do not consent to discussing my weight during consultations.”

Remember: You deserve to know the truth about Prediabetes and have the right to evidence-based treatment that addresses your actual health, not just weight loss recommendations.

This article, written by Dr. Asher Larmie, is based on current scientific evidence, including the 2018 Cochrane Review of 103 studies on prediabetes and the long-term results from the Diabetes Prevention Program Outcomes Study. This information, is provided for educational purposes and should not replace professional medical advice. Always consult with healthcare providers for personal medical decisions. For more detailed information and resources, check out Asher’s masterclass.