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Diabetes Testing Equipment

Type 2 Diabetes & Pre-Diabetes

Overdiagnosis through lowered HbA1c thresholds and the pre-diabetes label

Overdiagnosis concern

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Lowered HbA1c thresholds mean an estimated 1 in 3 UK adults meet pre-diabetes criteria, yet only 5–10% progress to diabetes annually, and a similar proportion return to normal without intervention. Measurement variability can result in up to 2,233 people per 100,000 screened being misclassified on a single test

1 in 3

UK adults meeting pre-diabetes criteria

5-10%

Annual progression rate to diabetes

2,233

Potential misclassifications per 100,000 screened

Resources​

Lowered HbA1c thresholds mean an estimated 1 in 3 UK adults meet pre-diabetes criteria, yet only 5–10% progress to diabetes annually, and a similar proportion return to normal without intervention. Measurement variability can result in up to 2,233 people per 100,000 screened being misclassified on a single test

BJGP: Pre-diabetes - opportunity or overdiagnosis? (2018)​

UK primary care perspective on the pre-diabetes label, diagnostic criteria and NICE guidance. British Journal of General Practice.

PMC: Beware of overdiagnosis harms from screening​

Covers overdiagnosis from lowered diagnostic thresholds including diabetes, with evidence on pre-diabetes progression rates.

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