Who has diabetes?

So how do we decide who has diabetes? When I was in medical school, our numerical rule was this: if you had a fasting blood sugar over 140, then you had diabetes. But in 1997 the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus redefined the disorder. Now if you have a fasting blood sugar over 126, you have diabetes. So everyone who has a blood sugar between 126 and 140 used to be normal but now has diabetes. That little change turned over 1.6 million people into patients.

Is that a problem? Maybe, maybe not. Because we changed the rules, we now treat more patients for diabetes. That may mean we have lowered the chance of diabetic complications for some of these new patients. But because these patients have milder diabetes (relatively low blood sugars between 126 and 140), they are at relatively low risk of these complications to begin with.

Welch HG, Schwartz LM, Woloshin S. Overdiagnosed: making people sick in the pursuit of health. Boston: Beacon Press, 2011: p17-18.

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