Mohammed K. Ali, MD, associate professor of global health at the Emory Rollins School of Public Health, is lead author on the paper. The researchers analyzed nationally-representative data from the U.S. National Health and Nutrition Examination Surveys between 1988-2014 and looked for both cardiovascular and renal burdens associated with prediabetes (a diagnostic label for those with blood sugar levels that are higher than normal, but not yet in the diabetic range).
‘There is controversy over the usefulness of prediabetes as a diagnostic label for cardiovascular and chronic kidney disease. Using data from US National Health and Nutrition Examination Surveys (NHANES) between 1988 and 2014, this research finds that these two diseases are highly common among individuals with prediabetes.’
Kidney and cardiovascular diseases associated with prediabetes
"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 ten years," says Ali. "Additionally, 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."
Patterns of cardiovascular and renal risk factors and diseases in people with prediabetes were compared with other glycemic status groups, including patients with diagnosed diabetes, undiagnosed diabetes, and patients with normal glucose levels. Research over the past several decades has shown a strong correlation between diabetes and both cardiovascular and kidney disease. Those years of research have driven practitioners around the country to focus on treating diabetes aggressively and comprehensively, which has led to substantial reductions in rates of heart disease in diabetic adults. Ali stresses the need for a similar approach when developing treatment plans for undiagnosed or prediabetic patients.
Reducing risk through lifestyle modification
"Depending on what definition you use, as many as one in three American adults has prediabetes-level blood sugars," says Ali. "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. References :
- Mohammed K Ali, Kai McKeever Bullard et al. Cardiovascular and Renal Burdens of Prediabetes in the USA: analysis of data from serial cross-sectional surveys, 1988-2014, Lancet Diabetes and Endocrinology DOI: https://doi.org/10.1016/S2213-8587(18)30027-5