With the recent focus on new hypertension guidelines, which broaden the inclusion circle for those with prehypertension, it is no surprise that other chronic disease states now focus on precursors to full-blown illnesses. A recent study conducted at the Emory Rollins School of Public Health and the CDC highlights the medical risks that patients with prediabetes face. The study, published in The Lancet in February, analyzed cardiovascular and renal burdens of prediabetes in the United States by examining data from serial cross-sectional surveys conducted from 1988 to 2014.

Because of the questionable impact of a predisease diagnosis, Mohammed K. Ali, MD, lead author of the study and an associate professor of global health at the Emory Rollins School of Public Health, emphasized the importance of this work. “Depending on what definition you use, as many as one in three American adults has prediabetes-level blood sugars,” says Ali.

Even though prediabetes blood glucose values do not meet the threshold for full-blown disease, Ali stresses that the elevated values are nonetheless medically impactful. “Prediabetes is extremely common, and its prevalence is growing. What we’ve seen through our analysis is that having high glucose levels is associated with a much higher risk of high blood pressure, high cholesterol, and an increased risk of having a heart attack in the next 10 years,” says Ali. Blood pressure is not the only problem according to the researchers. In addition to cardiovascular disease, there are also renal risks that traditionally correlate strongly with diabetes. “Over 11 percent of people with prediabetes have some type of kidney dysfunction, which is an early predictor that in the next 10-15 years, they may need to go on dialysis or receive a kidney transplant,” he said.

Ali points to research supporting comprehensive treatment of diabetes and the associated reductions in heart disease. Consequently, he recommends that similar interventions be used to treat patients with prediabetes. “Whether you’re a legislator or a leader of a large health system, our findings suggest that identifying this group is a huge opportunity for cardio-metabolic risk reduction. With a comprehensive approach [helping these patients improve their lifestyle choices, being more aggressive with efforts to lower cholesterol and blood pressure, and helping these patients stop smoking], there’s a real opportunity to lower this group's eventual morbidity and mortality risks,” said Ali.

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