See also: Sugar, obesity, and Alzheimer’s: A national crisis

In 2016, with health care costs on the rise and drug prices a political issue, why would any governmental body want to create 86 million more sick people?

Unfortunately, that is what the United States Centers for Disease Control and Prevention (CDC) has done by promoting the existence of a condition called "pre-diabetes."  Last month, they launched a website named doIhaveprediabetes.org, and tens of millions of people who take the survey will find that they do.

There is just one problem: it doesn't exist. 

Diabetes is a condition that occurs when the pancreas, and the insulin hormone it creates to allow for cells to absorb sugar, doesn’t function properly.  People with Type 1 diabetes were born with an autoimmune condition that results in the destruction of insulin-producing cells.  The condition where it is acquired later in life, primarily due to poor diet and lack of exercise, which leads to obesity and overtaxes the body's natural insulin regulation system, is Type 2 diabetes. 

So what is pre-diabetes?  Type 2 diabetes is determined by a blood test that measures hemoglobin A1c, which indicates average blood sugar level over the last three months.  People with an A1c blood sugar level over 6.5 percent can be diagnosed with diabetes, but some groups, including the American Diabetes Association (ADA), have recently started to claim that anyone with an A1c of 5.7 percent has a precursor that will be a harbinger of diabetes – "pre-diabetes."

There are numerous problems with this.  First is that in order for it to be a true medical designation, it would have to have clinical relevance.  A hemoglobin of 5.7 to 6.4 percent A1c does not predict diabetes the way actual impaired glucose tolerance does.  Another important issue is that diabetes can be life-threatening without medication, but the common medical treatment for Type II diabetes, metformin, shows little benefit versus risk at lower hemoglobin A1c levels.  Having even more people take it would see costs balloon, with poor chances of improvement and increased side effects such as diarrhea, headaches, and heartburn, all to prevent a disease they may never have gotten.

If the rest of the world adopted the CDC's pre-diabetes classification, half of China would suddenly have this new medical condition.  In the United Kingdom, the National Health Service would suddenly have 500 percent more diabetes-related patients.  Yet in other countries, people at those lower hemoglobin A1c levels don't show a significant progression to diabetes at all.  If a diabetic medical condition exists only for Americans, it is not a medical condition. For those reasons, the World Health Organisation (WHO) would prefer it not be used "because so many people do not progress to diabetes as the term implies," while the U.K. National Institute for Health and Care Excellence (NICE) says doctors need to "move away from describing 'pre-diabetes' as a separate condition." 

That hasn't stopped scholars in California from declaring that over half the state has this new condition.

The downside to letting a poor metric for a pathway to diabetes become medical practice is obvious: though the best way to prevent Type II diabetes is exercise and a healthy diet, when people are told they can't get medicine to prevent it, yet another aspect of health care will become a political issue – and that is not good for anyone.

Proponents argue that studies have begun to appear that support the existence of pre-diabetes, but that is not at all different from what we have seen in the past with papers on red wine, açaí berries, chocolate, and numerous other fad health beliefs.  When it comes to health, it is possible to create a "ghost army," where numerous poorly done studies all together claim to look like "weight of evidence."  Making medical decisions based on those is not good science or health policy.

Hank Campbell is the president of the American Council on Science and Health.