What is going on when 50% of a population have either glucose intolerance (prediabetes) or full blown diabetes?
In my previous article I posted about postprandial hyperglycemia. Postprandial hyperglycemia is a signal from the body that it is glucose intolerant. The course of action from here is to ask your doctor for an oral glucose tolerance test which either will result in a diabetes diagnosis or fall in the range above normal but below diabetes which is prediabetes.
Prediabetes does not mean the person will ever develop full diabetes. Prediabetes merely indicates that the person has a genetic tendency to develop diabetes and must adopt a lower carb diet and other good eating habits to prevent the beta cells from wearing out. Diabetes occurs once the beta cells produce no more insulin while prediabetes can happen because not enough insulin is being produced or because of insulin resistance (not enough muscle mass to absorb the sugar from the meal). The way to combat prediabetes is to build muscle mass, avoid letting the blood sugar spike above 130 (high spikes damage beta cells), and of course there are supplements known to help such as Metformin.
In my opinion anyone diagnosed with prediabetes should be on Metformin but I'm no doctor. It all depends on if the risk of developing diabetes is high enough to justify Metformin and this might depend on the individual patient, their diet, their genes, their age, etc. Humans of Chinese, African, Native American descent, often have the diabetes genes which make them more susceptible. If these genes can be tested for and identified in childhood then patients could be given Metformin before they even get prediabetes but of course this would be controversial in itself.
In my opinion and from my research experience BMI is a worthless measure and should be completely disregarded in favor of body composition (body fat percentage and total lean mass). If a person has more lean mass (muscle) and lower body fat percentage particularly then the risk of developing diabetes decreases quite a bit because muscle absorbs glucose, less fat means less fat around the belly area which is known to be the worst area. In studes Chinese are known to have diabetes are lower BMI but Chinese are also known to be smaller people in general with lower muscle mass as well which shows BMI is kind of pointless while body composition is precise to the individual (more muscle and less fat is almost always good for reducing diabetes risk).
For any doctors, what is the best option here? Should everyone with genetic vulnerability be given Metformin? Or should it be according to the risk score the person has of becoming a diabetic in 10 years?