Type 2 diabetes: 1 in 5 'healthy' people may have prediabetes metabolism

Impaired glucose homeostasis can indicate the body is failing to control blood glucose levels properly

ISLAMABAD, (Onine) - One in five adults considered medically “healthy” may actually have glucose metabolism similar to that of people with prediabetes.

In a recent study published in Mayo Clinic Proceedings: Digital Health, researchers from Klick Labs say they have developed a new analysis method that uses data from continuous glucose monitors (CGMs) to flag a precursor to prediabetes known as impaired glucose homeostasis (IGH).

“For people with diabetes, blood glucose levels can rise and fall like a wild roller-coaster ride with steep drops and peaks,” Jaycee Kaufman, the study’s lead author and research scientist at Klick Labs, said in a press statement.

“We found a similar pattern in patients with IGH, albeit those patterns were more like gentle waves than dramatic peaks, but intervention on this population could limit the likelihood of progression to full diabetes,” she added. Diagnosing prediabetes

Impaired glucose homeostasis can indicate the body is failing to control blood glucose levels properly.

The researchers said they were able to identify people with IGH using a new mathematical model. They enlisted 384 people and fitted them with a CGM.

The participants wore the CGM for two weeks and were assessed by a doctor. The participants were either diagnosed with diabetes or prediabetes or were considered “healthy” according to guidelines from the American Diabetes Association.

The researchers then applied their mathematical model to the data gathered from the CGM.

The study participants were then reclassified into two groups: those with impaired glucose homeostasis and those with effective glucose homeostasis.

“What was most surprising is that 20 percent of participants, who were assessed using the standard screening tools for diabetes and cleared as healthy by a physician, were then found to have impaired glucose homeostasis –reinforcing it is now possible to provide an earlier, more accurate and sensitive assessment of people’s diabetic status,” Yan Fossat, vice president of Klick Labs, said in a press statement.

Diagnosing and treating prediabetes early

“This new method of analysis is a major step forward in the prevention and management of diabetes,” he added. “Early detection and intervention is critical in the management of type 2 diabetes, so our method has the potential to have a significant impact on the lives of millions of people worldwide.”

In the United States, 37 millionTrusted Source people have diabetes. It’s estimated that more than 8 millionTrusted Source people are still undiagnosed.

About 38% of the adult population, or 96 millionTrusted Source people, have prediabetes. Nearly half of people aged 65 and older have prediabetes.

With early detection, prediabetes can be reversed.

“The earlier you catch prediabetes, the easier it will be to reverse it or stop the progression of it,” Dr. Pouya Shafipour, a family and obesity medicine physician at Providence Saint John’s Health Center in California who was not involved in the study, told Medical News Today. “And there’s less damage because the entire body gets sugar coated from eyes to nerves, the stomach to kidneys, to all the nerves in the toes. So the earlier we can get alerted and change our diet, change our habits, improve sleep, reduce anxiety, improve diet and improve eating behaviors, the less chance that we won’t have any long term damage. If you catch diabetes, when someone already has an advanced stage, then it’s still good. But at that stage, it might be very, very challenging to reverse.”

“That by itself, kind of snowballs into preventing a lot of things that a diabetic or pre diabetic is at risk for like heart disease, stroke, nephropathy, kidney damage, even certain cancers and dementia that are side effects of obesity or high insulin resistance,” he added.

Measuring blood glucose levels

Dr. Sun Kim, an endocrinologist at Stanford University in California who was not involved in this study, says that while the advance of CGMs has meant progress in the management of diabetes, there is not yet a need for everyone to wear one.

“Before CGMs we really only had the blood tests. In the past, it was very hard to measure your own glucose. If you go back, a century ago doctors are testing urine to see if someone had abnormal glucose. From that advanced to blood testing, to continuous glucose monitoring.

We’ve really gone a long way,” she told Medical News Today.

Practically however, Kim says there is not enough evidence for the broader population to wear a CGM to screen for prediabetes.

“Do I feel like everybody in the population should wear a CGM? No… I’m not sure that there is necessarily a population benefit for that,” she said.

Shafipour argues that even if CGMs were widely available and covered by insurance, and the mathematical model in the study was used, there is more needed in the management of prediabetes and diabetes.

“When we’re addressing this, we need to take a lot of things into consideration. But the mainstay of it is to focus on the type of calories, timing of eating, frequency of eating, level of physical activity, not just exercise, but non-exercise activities, such as parking the car farther, using the stairs instead of elevator and being more active in the lifestyle as well as making sure mental health is under check. We’re addressing anxiety, depression, making sure that people are getting quality sleep. So it’s a lot more complex and the earlier we can address these, the more beneficial this will be in the long term,” he said.