35.3% of British adults are likely to have prediabetes. Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, argues that increased diabetes testing is needed to ensure 18 million people don’t go on to develop ‘full-blown’ diabetes
Up to 18 million UK adults could have prediabetes – which means they are on the verge of developing type 2 diabetes. That’s considerably higher than the 7 million figure that is usually quoted.
London Medical Laboratory’s analysis of the latest research into prediabetes raises some big questions. Why is the potential number of people with prediabetes so high? More importantly, how can we prevent them from developing ‘full-blown’ type 2 diabetes, creating massive pressure on the NHS and altering millions of lives?
The potential prevalence of prediabetes
Prediabetes means that blood sugars are higher than usual but not high enough for someone to be diagnosed with diabetes. However, it does mean that anyone with the condition is at high risk of developing type 2 diabetes. People with prediabetes (also known as Impaired Glucose Regulation or non-diabetic Hyperglycaemia) have higher than normal blood glucose levels, suggesting early features of diabetes. Recent research has shown prediabetes may already be causing long-term damage to the body, affecting the heart and circulatory system.
Concerningly, prediabetics are unlikely to experience any symptoms, meaning the condition goes unnoticed even at the threshold of type 2 diabetes when irreversible damage has already occurred. In 2019, there were almost 14,000 diabetes-related deaths in the UK. The earlier people are diagnosed, the better the outcome.
How much of an upset are these latest results? The most commonly quoted figure for the number of people who have prediabetes is around 7 million. That figure dates back to 2009 research by Diabetes UK. The same organisation released updated estimates two years ago, suggesting 13.6 million people were at risk of developing diabetes.
Even that figure is far less than the latest finding of 35.3% of UK adults, equating to 18 million people, based on results from the most comprehensive research into prediabetes ever conducted in the UK. This study, published on the British Medical Journal’s ‘BMJ Open’ website, found that 35.3% of randomly selected participants were prediabetic. Growing obesity rates and an increasing population (there are now 53 million adults in the UK) mean that some 18.5 million Brits are now likely to be prediabetic.
How can diabetes testing help?
Increased diabetes testing is needed to establish which of us are among this at-risk population. For that reason, the ‘Healthier You’ NHS Diabetes Prevention Programme must succeed. The programme identifies people at risk of developing type 2 diabetes and refers them to a nine-month, evidence-based lifestyle change programme.
The Healthier You programme is available both as a face-to-face group service and as a digital service. When referred to the programme, people are free to choose between the two. The NHS says its Healthier You programme cuts the risk of developing type 2 diabetes by more than a third for people completing the programme. It is delivered across England by a range of providers.
The most accurate test to identify prediabetes and alert health professionals that a patient may need referring to the Healthier You programme is known as the HbA1c test, which can be done at local medical practices but is now available as a home finger-prick test.
What will these test results tell you?
- An HbA1c of 41mmol/mol or below is considered normal
- An HbA1c of 42 – 47 mmol/mol is considered in the prediabetic range
- An HbA1c of 48mmol/mol or above indicates that you have diabetes
Remember, type 2 diabetes can come on slowly, usually in people over the age of 40. The sooner this problem is detected the better we can manage it. Those who discover they have prediabetes should take it as a warning sign that they are at substantial risk of developing type 2 diabetes. The good news is that prediabetes is not ‘full’ diabetes yet and with the right support, up to 50% of cases of type 2 diabetes can be prevented or delayed.
