Ever hear someone describe herself as pre-pregnant? Of course not! You are either pregnant or you are not! When I trained forty years ago, I was taught that the physiologic changes of diabetes started ten years prior to the clinical diagnosis of diabetes. Despite all the advances in our understanding of diabetes in the last forty years, very little has changed.
According to Medpage Today, the incidence of diabetes continues to rise. “An estimated 25.8 million Americans, or 8.3% of the population, have diabetes and almost a third don’t know it, the CDC said.” That is a staggering figure. “Another 79 million people have pre-diabetes, with high fasting glucose or hemoglobin A1c levels but not quite at the frank diabetes level.”
In the midst of an epidemic of diabetes, the medical world continues to be politically correct and it tells patients that they have a precondition entity and they have time to do something. It is my belief that understating the magnitude of the problems associated with diabetes is one of the driving forces behind the rise in the incidence of diabetes.
From my point of view, pre-diabetes is as absurd a diagnosis as is pre-pregnant. So why do physicians soft sell the diagnosis of diabetes? In my opinion, there are several answers:
- There are insurance implications involved in making any diagnosis. Pre-diabetes does not carry additional risk of being rated by the insurance industry.
- There is a stigma associated with the diagnosis of diabetes.
- Diagnosing diabetes means having to teach about diabetes, blood sugar monitoring, medications, diet and lifestyle modification. Education takes time and is rarely paid for by insurance companies.
- Patients do not want to hear that they have diabetes.
So, what’s the big deal? Knowledge is power! If you know you have diabetes and you know what you need to do to treat diabetes, then you have the power to reverse or control the disease. When you have a “sort of diagnosis” that requires you to change your lifestyle to prevent a disease you don’t really have and may never get, you “sort of” address it and will get around to it in time. Meanwhile, the physiologic changes of diabetes continue to erode your health.
On a daily basis, Docs see and diagnosis some of the 79 million patients who have pre-diabetes, hyperglycemia, elevated blood sugar, abnormal glucose metabolism and other names ascribed over time to this condition. Someone once said, “The devil comes in many disguises.” Undiagnosed diabetes is the devil; and the sooner you recognize the devil, the easier it is to get him out of your life.
The next time your doctor tells you your blood sugar or hemoglobin A1c is slightly elevated, think early diabetes. Regardless of what your doctor calls it, take it seriously. A diabetic diet and diabetic lifestyle are a healthy diet and lifestyle. If we all adopted the diabetic lifestyle, the numbers of patients diagnosed would fall precipitously. It is not as simple as “cutting out sugar”. Sugar is not bad. Nature does not produce “bad” foods; there are just foods that are abused and misused.
