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Misdiagnosis By Design - The Story Behind the ADA Diagnostic Criteria

This is the little known story of how--and why--the American Diabetes Association keeps doctors from diagnosing Type 2 diabetes early.

If you wait for your doctor to give you a diabetes diagnosis, the chances are good that by the time you are diagnosed you'll already have one or more serious diabetic complications. These include retinal damage, nerve damage, and early kidney damage. It is now known that these diabetic complications only develop after years of chronic exposure to high blood sugars. But, tragically, the way that today's doctors are forced to diagnose diabetes ensures that you will get no warning that you are experiencing those chronically high blood sugars until they have reached a level so high they have already done irreversible damage.

This is not an accident. Years ago a committee of medical experts whose task was to decide how diabetes should be diagnosed decided it was better to avoid diagnosing patients with diabetes than to give them early warning that they were suffering from elevated blood sugars. As a result, these medical experts intentionally set the standards for diagnosing diabetes artificially high, so that most patients do not get diagnosed until their blood sugar has reached a level where they may soon develop the diabetic eye disease that leads to blindness.

Their reasons for doing this this made sense in the late 1970s when these diagnostic criteria were originally crafted. At that time there was no treatment that could help people with early diabetes, while delivering a diabetes diagnosis could make it impossible for their patients to get health or life insurance. These circumstances led the experts to conclude that an early diagnosis of diabetes was more likely to harm than help their patients. So they defined diagnostic criteria that wouldn't diagnose patients with diabetes until late in the disease process, when their blood sugars were bad enough that they could safely use insulin and the early insulin stimulating drugs. These were very unsafe to use in the late 1970s unless patients had extremely high blood sugars, since patients had no access to real time blood sugar testing, as there were not yet any blood sugar meters available to patients for home use.

More at the link. Things are more proactive now.