A third of adults over the age of 45 who don’t look like they could be at risk for developing diabetes — they’re slender — may actually meet the criteria for prediabetes, according to a University of Florida College of Public Health and Health Professions study.
The findings are cause for concern, the researchers say, because under current guidelines, these individuals would likely not be screened for the condition. The study results appeared July 11 in the Annals of Family Medicine.
Prediabetes is defined as having blood glucose concentrations higher than normal, but not high enough for a diabetes diagnosis. The condition puts people at higher risk for developing Type 2 diabetes and cardiovascular problems.
“We have an epidemic of diabetes right now and diabetes prevention is a key strategy to try to stem that tide,” said lead investigator Dr. Arch G. Mainous III, chair of the department of health services research, management and policy at Florida. “One of the ways we can do this is to identify people with prediabetes, a high-risk state for development of diabetes, and intervene with drug or lifestyle modifications to keep them from transitioning to diabetes.”
Recommendations from organizations such as the American Diabetes Association and the U.S. Preventive Services Task Force call for prediabetes screenings in individuals who are overweight or obese. The Florida research team wanted to learn if using BMI measures alone may be missing people who are considered to be at a healthy weight, but could benefit from prediabetes screening and potential intervention.
In what is believed to be the first study to examine trends in prediabetes prevalence among individuals with a healthy body mass index, the team analyzed data from the National Health and Nutrition Examination Survey, a nationally representative study that uses a combination of interviews and physical examinations. The Florida researchers reviewed survey data from 1988 to 1994 and 1999 to 2012, focusing on adults age 20 and older who had a BMI within the healthy weight range — 18.5 to 24.9 — and who did not have a previous diagnosis of diabetes.
The prevalence of prediabetes, categorized by a blood glucose level between 5.7 and 6.4 percent, which the American Diabetes Association considers prediabetes, varied by year, but tended to increase overall. By 2012, 19 percent of adults age 20 to 44 at a healthy weight had a blood glucose reading that met the criteria for prediabetes, and 33 percent of adults age 45 and older in the healthy weight range met the criteria.
“A large proportion of these people will develop diabetes, but we won’t be able to do any diabetes prevention with them because we aren’t looking for them under current screening guidelines,” said Dr. Mainous, the Florida Blue endowed chair of health administration.