One of the great barriers to motivating those with prediabetes is that most people don’t feel any symptoms, and thus there is little urgency around the condition. One way of increasing urgency is by working to frame prediabetes more clearly as a legitimate medical condition. Lucia Novak, Director of the Riverside Diabetes Center at Riverside Medical Associates (Riverdale, MD) and Adjunct Assistant Professor, Uniformed Services University of the Health Sciences, suggested that prediabetes “probably should be called stage one diabetes.” Prof. Campbell agreed, noting, “I am a big believer in treating pre-diabetes as if it’s a diagnosis of type 2 diabetes.” Being able to visualize the physiological changes involved in prediabetes, even if you can’t feel them, might also increase the urgency. Said Dr. Vigersky, who is interested in the use of CGM to motivate behavior change, “The concept of glucose, let alone A1c, is so foreign [to people with prediabetes] . . . But if you show them a picture of what is actually happening [after a meal, etc.] . . . they could see some relationship. They could get an understanding in the simplest terms.”
Beyond a sense of urgency, basic awareness of prediabetes is also lacking. The condition is significantly underdiagnosed, and many patients don’t even get screened. In fact, 1 in 3 American adults, or a total of 84 million Americans, have prediabetes, but only an estimated 1 in 10 of those people are diagnosed.[i] Michael Warburg, managing director at Warbros LLC, said that few people know their prediabetes risk in the same way that they would be likely to know, say, their cholesterol number. He said, “I’d like to see A1c as part of everyone’s personal dashboard,” one that is screened for as standard practice and that holds the same prominence in people’s sense of their own health as cholesterol or BMI.