Diabetes may begin years before diagnosis

Turns out, early signs of type 2 diabetes are identified more than 20 years before diagnosis.

A new research presented at this year's European Association for the Study of Diabetes (EASD) Annual Meeting in Germany, found that increased fasting glucose, higher body mass index (BMI) and impaired insulin sensitivity were detectable up to 10 years before the diagnosis of diabetes as well as prediabetes.

Lead author Dr. Hiroyuki Sagesaka said, "As the vast majority of people with type 2 diabetes go through the stage of prediabetes, our findings suggest that elevated metabolic markers for diabetes are detectable more than 20 years before its diagnosis."

 

Sagesaka and colleagues assessed the trajectories of fasting blood glucose, BMI, and insulin sensitivity in individuals who developed diabetes and prediabetes separately.

At the start of the study, 27,392 non-diabetic individuals had a fasting glucose and average blood glucose (HbA1c) measured and were followed until a diagnosis of type 2 diabetes or prediabetes, or the end of 2016, whichever came first.

Previous research suggests that risk factors like obesity and elevated fasting glucose may be present up to 10 years before someone is diagnosed with diabetes. However, the time point at which individuals who go on to develop diabetes and those who don't first become substantially different from each other was not known until now.

The research has important implications given that an estimated 425 million adults (aged 20-79 years) were living with diabetes in 2017, and this is predicted to rise to 629 million by 2045.