Risk, the prediabetes diagnosis and preventive strategies: critical insights from a qualitative study

Abstract

Diagnosis constitutes a major categorisation tool in medicine. This paper adds to the paucity of knowledge about part of the work such a tool performs. It examines the ways in which diabetes epidemiology translates into attempts to prevent diabetes from occurring through screening and diagnosing, and then managing those categorised as ‘at high risk’. Using a qualitative design in the context of a small-scale Danish intervention study, the findings suggest that health professionals overinterpreted relative risk reductions and exaggerated treatment effects; simultaneously, prediabetics called into question the scientifically set thresholds. Nonetheless, arguments concerning changed behaviour’s benefits were sought to be incorporated into self-care routines. The data highlight how, by identifying a normatively set threshold, a diagnosis can determine health promotion messages’ impact in ‘high-risk’ prevention strategies.

Keywords:

• prediabetes
• risk
• screening
• health promotion

Acknowledgement

Many thanks are due to Nete Schwennesen for her excellent substantive comments on an earlier version of this paper.

Funding

This paper is financed by internal funding from Steno Diabetes Center. Steno Diabetes Center receives part of its core funding from unrestricted grants from the Novo Foundation and Novo Nordisk A/S. The funder, Steno Diabetes Center provided support in the form of salaries for authors ALH and JAAH, but did not have any additional role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.