We often hear that preventing a disease is better than curing it. In the world of diabetes prevention, this has typically meant adopting healthier lifestyles, especially for those in the “pre-diabetes” stage.
However, fresh research suggests that the conventional approach to staving off diabetes might not work for a substantial chunk of people at risk.
The Complexity of Pre-diabetes
Pre-diabetes is a condition where your blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes.
A significant number of people worldwide have this condition, and thus, are on the brink of potentially developing diabetes. Among Australians, a staggering two million are grappling with pre-diabetes.
Historically, lifestyle adjustments, particularly alterations in diet and physical activity, have been the go-to strategy to thwart the transition from pre-diabetes to type 2 diabetes.
But the effectiveness of these lifestyle interventions is now under the microscope, with new research suggesting they might not be universally beneficial.
Differing Impacts of Lifestyle Changes
A collaboration of researchers from the U.S., U.K., India, and the Baker Heart and Diabetes Institute has brought to light some disconcerting findings.
Their research, spearheaded by Dr. Sathish Thirunavukkarasu and outlined in Diabetes Care, investigated the efficacy of traditional lifestyle interventions among different types of pre-diabetes.
While examining data from randomized controlled trials globally, they found that while diabetes incidence significantly dropped in individuals with a specific type of pre-diabetes known as impaired glucose tolerance, there was no effect observed in those with isolated impaired fasting glucose, a condition that constitutes a large segment of the worldwide pre-diabetes population.
This is particularly concerning, considering that isolated impaired fasting glucose not only increases the risk of developing diabetes by four to six times but also poses a heightened risk for cardiovascular diseases and even death.
Professor Jonathan Shaw, a Senior author and the Head of Clinical Diabetes and Epidemiology at the Baker Institute, highlighted that recent analysis found 58% of Caucasians and 48% of Asians with pre-diabetes had this specific form, isolated impaired fasting glucose.
Exploring New Avenues for Prevention
The current findings underline a pressing need to rethink and refine our approach to diabetes prevention.
Professor Shaw mentions some potential alternative strategies, like adopting a low-calorie diet or engaging in high-intensity interval training, which have been shown to effectively regulate fasting plasma glucose levels and even reverse the pathophysiology in people with type 2 diabetes.
Professor Anthony Russell, President of the Australian Diabetes Society, emphasized that these findings could necessitate revisions in how testing for pre-diabetes is done and how lifestyle interventions are tailored and offered in Australia and potentially globally.
The Australian Federal Government, currently conducting an inquiry into diabetes, which includes scrutinizing the evidence around the prevention, diagnosis, and management of diabetes in Australia, must integrate these findings to ensure a more nuanced and effective approach to diabetes prevention.
In essence, the discovery that not all pre-diabetes is created equal prompts a pivotal shift in perspective: the strategies for diabetes prevention need to be as diverse and specialized as the populations they seek to protect.
Future efforts must dig deeper to uncover effective interventions for all shades of pre-diabetes and refine prevention strategies to ensure they’re robust, inclusive, and scientifically substantiated.
If you care about diabetes, please read studies that pomace olive oil could help lower blood cholesterol, and honey could help control blood sugar.
For more information about health, please see recent studies that blueberries strongly benefit people with metabolic syndrome, and results showing eggs in a plant-based diet may benefit people with type 2 diabetes.
The research findings can be found in Diabetes Care.
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