Pre-diabetes: Public health time bomb … and industry opportunity

According to the World Health Organisation (WHO), type 2 diabetes affects over 220 million people globally and the consequences of high blood sugar kill 3.4 million every year.

Indeed, it is projected that by 2025 there will be 380 million people with type 2 diabetes and another 418 million people with impaired glucose tolerance – a pre-diabetic state. While by 2035 it is expected that 471 million people, equating to 8% of the adult population of the world, will be classed as pre-diabetic.

This additional burden of risk and cost from pre-diabetes is seen by many as a ticking time bomb for public health, and comes at a time when the WHO has already said that the world is suffering from a diabetes epidemic.

Yet this ‘time bomb’ may also be an opportunity for the food and drink industry, who can help to defuse the risks of progression to diabetes through lifestyle changes and the development of healthier products and ingredients.

“With obesity and diabetes established as the most pressing public health concerns, snacks that provide excess calories and carbohydrate must be viewed as a major component of the problem,”​ said researchers writing in Physiology & Behavior​​ – adding that as such, those foods and snacks which can help to reverse such trends are an opportunity for the industry.

“In the past, snacks were designed mostly for taste and convenience. We need snacks with nutritional value and metabolic purpose.​”​ they wrote.

The ticking bomb​

Pre-diabetes (also referred to as impaired glucose regulation) is a pre-diabetic state where either impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) have been identified in a person, but there is no diagnosis of full (or overt) type 2 diabetes.

It has been repeatedly shown that those with pre-diabetes are significantly more likely to develop full type 2 diabetes (T2D), than those with normal blood glucose levels – with estimates of one year profession suggesting that those with isolated IGT have over five times the risk, those with isolated IFG have seven times the risk and those with both IGT and IFG have over 12 times the risk compared to people with normal blood sugar. 

“The percentage of population who are pre-diabetic, with IFG or IGT is much greater than that of diabetic patients and is persistently increasing,”​ said researchers writing in Diabetes & Metabolic Syndrome: Clinical Research & Reviews​.

Aside from the obvious increased risks of developing T2D, people classified as pre-diabetic are also at high risk of cardiovascular disease (CVD) – including stroke, coronary artery disease, and peripheral vascular disease.

According to research conducted in Saudi Arabia, pre-diabetics is often characterised by, or accompanied by, significant weight gain or obesity (especially central obesity), dyslipidemia, significantly increased HbA1c, reduced total antioxidant status, and more sedentary lifestyles – when compared to those people with normal blood sugar management.

Links to obesity, poor diet, and a lack of exercise have been repeatedly found in studies all over the world – suggesting that reversal of these trends could have a major impact on pre-diabetes and the risk of progression to type 2 diabetes.

An opportunity to defuse​

Reversing pre-diabetes, and even diabetes, through lifestyle alterations has been repeatedly been shown to be possible, and provides responsible food and drink manufacturers and ingredients suppliers with a massive market opportunity. 

Indeed, studies have shown that lifestyle changes including increasing exercise and changing dietary habits can delay the progression of pre-diabetes, and even reverse it.

According to the UK government, this potential can provide big opportunities for the industry, as food and nutrition companies look to develop new products that are healthier.

Indeed, by fortifying foods with micronutrients, reducing sugar, and increasing fibre content – to name just a few - it is possible that the industry can produce making healthier foods that can help consumers to battle pre-diabetes, while improving their brand image to boot.

Recent years have seen a swathe of research and development in the area, as companies begin to move in to this potential lucrative market space.

From, reducing sugar, increasing fibre, cutting calories, and slashing salt, to adding in functional ingredients that have been linked to lower risks of diabetes, there is much potential.

There has been much research, for example, investigating the links between vitamin D​ and diabetes progression, while several studies have suggested that high-protein diets – especially in the morning​ – can help with blood sugar management, and reduce the risk of pre-diabetes progression.

From the potential of polyphenols​, to the use of sugar alternatives like Palatinose, the possible benefits of cocoa​, yoghurts​, and newly discovered fatty acids​ – there is no shortage of approaches to battling pre-diabetes.