Dubious diagnosis

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Science  08 Mar 2019:
Vol. 363, Issue 6431, pp. 1026-1031
DOI: 10.1126/science.363.6431.1026

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The war on "prediabetes," a diagnosis applied to 84 million people in the United States, has been shaped by uncertain science and backed by entities with clear conflicts of interests, according to this investigative report. What started in 2001 as an effort by the American Diabetes Association (ADA) to persuade complacent doctors and the public to take small elevations in blood glucose more seriously quickly turned into a massive medicalization of what was previously considered normal. ADA then broadened its definition of prediabetes to include many more people, and the Centers for Disease Control and Prevention followed suit. Other experts accuse those authorities of "scaremongering." Call for urgent action on prediabetes aren't well-supported by medical and epidemiological data, specialists say. The growing population with prediabetes represents a marketing opportunity for drug- and devicemakers, which has opened the nonprofit ADA to charges of conflicts of interest.

  • * Jia You and Meagan Weiland contributed reporting. This story was supported by the Science Fund for Investigative Reporting.