The Ad Council in partnership with the ADA, AMA, and CDC has produced a series of public service announcements to help people identify whether they have pre-diabetes and what they can do about it. You can find them online at https://doihaveprediabetes.org/.
Clearly they were going for a jocular approach. But do you think they hit the mark or missed the point?
Not sure if itāll attract attention and motivate those that need to be motivated to make changes.
What really caught my attention, however, is that the AMA, the ADA, and the CDC all seem to be onboard with the use of the term reverse, as in reverse pre-diabetes.
Am I the only one that thinks this is an important word distinction and the medical professionals seem to be going along with snake oil sales techniques? I feel like some marketing-centric types were assigned this campaign with little input from medical experts.
No, youāre not.
And while weāre on the subject of misused words, IMHO there is no such thing as āpre-diabetesā. The term itself is a con.
Largely agreeā¦ Doesnāt really make any more sense than pre-hepatitis, pre-HIV or being pre-pregnant.
That said, moderate elevations of glucose levels are a common indicator of generally poorer health, and are likely reversible with lifestyle changes in many cases IMHOā however, this is a separate matter from having the disease of diabetes and confusing the two isnāt really a good thingā which to me is the problem of the āprediabetesā concept.
Iāve written this before. I think pre-diabetes is really stage 1, type 2 diabetes.
The ad also uses āpreventā and ādelayā in the pre-diabetes context. I think there is some truth that type 2 diabetes can be delayed if fairly drastic action is taken and sustained. Iām aware of Franziska Spritzlerās case, also know as the low carb dietitian, where through changing her diet, had normalized her blood sugar numbers. Iām working from memory but I think she had some elevated fasting numbers and also some post-prandial numbers above 140 mg/dl. She knew enough to take heed and do something about it.
I donāt think thereās any way, however that Franziska, reversed her metabolic situation. I believe (and she probably does too) that if she went back to the standard American diet, she would likely be back on the slippery slope to full-on type 2 diabetes. If anything, she arrested her condition and prevented the disease progression. She did not cure (another name for reverse), in my honest opinion, her propensity to become a diabetic.
Believe it or not I came across one of these today in the wild, and I cannot recall where. Hey it caught my attention, I read it. My comment at the time was 'if you have prediabetes you have diabetes, Take action".
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Either your body can regulate its blood sugar unassisted, or it canāt. There can be (and are) extremely mild cases of diabetes, but there aināt no such thing as āpreā. $0.02
But hereās why itās also a con: because it gives medical professionals an easy excuse to give short shrift to the patient. (āItās only pre-diabetes, I donāt need to spend time on it.ā) You can sugarcoat that semantically any one of a dozen ways, but what it boils down to is deliberate neglect of an entire class of patients. Which, of course, heightens the odds that ārealā diabetes (i.e., more pronounced symptoms) will sooner or later result.
Iāve wondered about this before. My father-in-law says he HAD pre-diabetes. He had a slightly elevated A1C. He drastically changed his diet and is low-carb, low-fat, low-calorie (not sure how he functions, to be honest - he eats celery, 0% yogurt, and turkey). He does weight training 5 days a week. And now he says he isnāt pre-diabetic anymore. (He doesnāt test his blood sugar at home, this is only based on A1C).
Is it just that if he ate more ānormally,ā he would have the same issue again?
Almost certainly. What he has doneāalong with thousands of othersāis to have achieved and maintained good control, and for that he deserves congratulations; itās hard work. But the underlying condition doesnāt go away. Itās waiting in the wings, so to speak. Remove the control, and it usually reasserts itself. (Thatās why so many of us bristle at the word ācureā; control isnāt cure. Cure is, itās gone and you donāt need to pay any further attention to it, as when antibiotics cure your infection.)
Of course there are exceptions to almost everything, but in the case of diabetes, the chance of being one isnāt much better than the odds of winning a national lottery.
This is just a continuation of a failure of the health system and our government to use the proper terms. It is so deeply embedded that it seems impossible to stop. The Diabetes Prevention Program claims that the demonstrated the āpreventionā of diabetes when in fact all they showed was that you could control and arrest the progression of diabetes. The continued use the terms prevention, reverse and cure are now pervasive. If you talk to most doctors they will tell you that ālifestyleā causes diabetes and that you can prevent, reverse or even cure diabetes by making lifestyle changes. Lifestyle doesnāt cause diabetes, it is more likely that diabetes is mostly caused by genes.
I like the idea of a public service message, I just think the message is messed up and in the end may do more harm than good.
But if those same behaviors that arrested the progression were adopted culturally and throughout life spans BEFORE people had diabetesā¦ How is that different from prevention?
Huh? Since we didnāt recognize diabetes in most of human history then we must have prevented it? Did I interpret what you said wrong?
Well I donāt know if Iād say we deliberately prevented it, but somehow the environments we lived in were less conducive to people developing diabetes in past generations than they are nowā people were eating better quality more natural foods and tended to be more physically active and did more laborious jobs for a livingā just for a couple examples.
Now we live in an environment where diabetes has become more prevalent, so I do think that we can make changes to our environment, culturally, that would decrease the prevalence of diabetesā¦ And that would be a form of prevention wouldnāt it?
I know some people take issue with that bc they think it is somehow āblamingā but itās really not
I agree that Diabetes should be diagnosed in stages. One problem with the pre-diabetes term is that diagnosis at an early stage tends to be assumed itās Type 2. Iāve already run into the problem with doctors coding it that way when I am in the early stages of autoimmune diabetes (LADA). My endo uses abnormal glucose as the diagnostic code so that I have access to the meds to treat it.
Off-base? No. You hit the bullseye right in its very center!
We had a family friend that was diagnosed with Type 2 diabetes something like 30 years ago. Her glucose levels were high, and she was hospitalized at the time of Dx ā I know she had ketones, though I do not know if she was DKA at the time. They started her from the beginning on insulin. This person took control, started exercising (mostly walking) and lost weight. In a very short time, she was off all medication and maintained healthy blood sugars. This lasted for many years; however, a few years ago, she fell and broke a hip, which of course prevented her fitness walking ā and just like that, she had to go back on insulin shortly thereafter.
Reverse Type 2? No, not thru lifestyle changes. Iām not even sure Iād call it ādelayā ā whether in the early stages (which, I agree, @David_dns, is wrongly called pre-diabates) is an appropriate word. Lifestyle changes can help MANAGE Type 2 diabetes in some - even many - cases. More than that is over-reaching.
OTOH, I do agree with the medical community on one thing: People will benefit from more screening.
I donāt like the pre-diabetes terminology at all but if the doctors stopped using this as a euphemism and described pre-diabetes as the slippery slope that it is, maybe people would take heed and not reflexively respond with denial. āMy doctor told me I have a touch of sugar,ā kind of denial.
Now maybe the doctors are giving their patients a more sober message. I think people need to understand just how serious this designation is and that going forward their life could be filled with many nasty diabetes complications. Perhaps every pre-daibetes diagnosis should be accompanied by a series of classes that fully inform the patient about just how vulnerable they now are. I also think if the medical community would open their eyes and recommend some reasonable carb-limits, maybe at few more of their patients would do better.
I couldnāt endorse Terryās view more strongly. The fundamental value and importance of early detection, and the resultant ability to intervene when thereās the opportunity to exercise real leverage, seems to be thoroughly understood everywhere.
Except when it comes to diabetes.
Iām a little confused, maybe someone can make some sense of this for me. I personally tend to agree with @David_dns.
However, I have two friends, both mothers. They both of have histories of type 2 diabetes in their families. Heck, so do i, and I ended up with the worser version in my opinion.
So both were considered obese, both were considered pre-diabetic, elevated A1cās.
They both adjusted their food choices- changed their diets, exercised more than before, which was nothing, and also cut out certain foods due to major food allergies. Now, their A1cās are normal again and their doctors say that as long as they continue to lose weight until BMI is in healthier range, docs feel they will be in the āclear.ā Both were not taking meds what-so-ever. They both continue to lose weight and are doing well. So was it the extra weight that caused the "pre-diabetes? Which was originally caused by the potential poor diet and no exercise?
This challenges my views, the proof is in the pudding, right?
I have type 2 diabetes in my family, on my fatherās side. I did everything opposite of my dad, ate right, exercised, maintained a healthy weight, and went to the doctor every 6 months. Now I have diabetes. So this tells me there is something more here in my genes than my friends maybe?
Anybody have any more thoughts from this?
Donāt know what to think now,
Busybee
I wanted to contribute a perspective less about the word āpre-diabetesā or āreversingā and more about the specific approach within the videos for the campaign, which I am embedding below (the ones in English), with my views on how each of them resonated for me:
This video essentially embedded (for lack of a better term) the pre-diabetes quiz WITHIN the video. I feel they did so in a very ingenious way, making it fairly effective in the end:
(hereās the Spanish version which felt just as effective.).
This video pokes fun at bacon lovers. Fundamentally, I liked itā¦ but it starts to get a bit too much towards the end, when the doctor pops the bacon loverās bubble:
(they made no Spanish version or an equivalent for this one)
The ābusy momā video REALLY didnāt do it for me. Not only did it feel less funny. Nearly every mom I have asked about it has confirmed: it feels like a slap in the face, considering something that actually IS respectable (unlike bacon lovingā¦ Which I share, but itās just not a good apples to apples comparison).
(hereās the Spanish version, which felt just as insulting)
Having said all this, the reality is that if this campaign makes the mark, raises the profile of pre-diabetes in the national dialog, and ultimately helps curve the type 2 diabetes epidemic through impacting the pre-diabetes epidemic, it matters little what I think about the use of sarcasm as a core element of the campaign.
Whatās your take on the videos used to support the campaign?
