Observations on ‘Prediabetes’

Changes in the Glucose Tolerance of Obese Subjects After Weight Reduction

“…It is evident that a large proportion of the 39 patients showed decreases both in the fasting blood sugar and in the rise following the ingestion of the test dose of glucose, and that both changes were significant. Examination of the data available in other reports (6,7,8) shows that such findings are usual when reduction in the weight of obese subjects is brought about by dietary therapy.…”

“…During the past four years the number of patients studied has increased greatly and a fair proportion has been reduced approximately to normal weight by dietary therapy. It has seemed desirable to examine the question again at this time, for in several recent papers (6,7,8) it has been suggested that reduction of weight has a definite effect upon the glucose tolerance.…”

“…In 1931 Tyner (19) stated that the rise in blood sugar following Brill's test meal (20) was less marked after 12 patients had been on a restricted diet than it was when they were first seen. In three more recent papers (6,7,8) other experiments are described. In each of these later studies attention was centered upon the dietary treatment of patients selected because some abnormality of the glucose tolerance test was found in a preliminary examination.…”

“…Since most of the authors who have studied changes in the glucose tolerance test during weight reduction (6,7,8) have chosen as subjects persons with distinctly high initial tests, and since the patients discussed in the present paper were not selected in this way, the data were studied to see first, whether there was any correlation between the initial tests and the changes observed after treatment, and, second, whether the patients with tests which were approximately normal showed changes similar to those noted in the majority of the subjects. The correlation coefficient between the sum of the initial four blood sugar concentrations and the change in that value after treatment was + 0.32 + 0.10, probably denoting a significant but not a very marked correlation.…”

“…They believe that the following conclusions are justified. Most, although probably not all (6,14,15,16) patients with obesity, show some abnormality in the tolerance for glucose. This abnormality can usually be markedly improved by weight reduction through dietary therapy.…”