022 From early detection to overdiagnosis: a qualitative exploration of lived experiences with prediabetes and mild diabetes in Canada
Bibliographic record
Abstract
Objectives The terms ‘prediabetes’ (6.0% ≤ A1c ≤ 6.4%) and ‘mild diabetes’ (6.5% ≤ A1c ≤ 7.0%) describe conditions where blood sugar levels are elevated but still fall within the treatment targets set by national guidelines and specialty societies for type 2 diabetes. While some view these diagnostic labels as offering opportunities for early intervention and delaying disease progression, there are concerns regarding overdiagnosis, with potential consequences including over-testing and overtreatment. Currently, there is limited understanding of patient experiences and priorities regarding the diagnosis and management of pre- or mild diabetes. Method We conducted a qualitative study engaging individuals recently diagnosed with pre- or mild diabetes, in collaboration with health services researchers, healthcare professionals, and patient research partners. Following the Patient Engagement Framework from the Strategy for Patient Oriented Research (SPOR), we worked with three patient research partners from British Columbia, Alberta, and Ontario, Canada. Together, we obtained funding, designed and conducted pre-interview surveys and interviews, and analyzed data to better understand patient experiences and priorities. We used reflexive thematic analysis, following Braun and Clarke’s approach, to develop meaning-based themes. Results Twelve adults have participated in this study so far, with four to eight more anticipated. Of all participants 66.7% had prediabetes and 33.3% had mild diabetes. The majority (58.3%) of participants were in the 40–60 years age range. We developed three main themes: i) While experiencing a range of negative emotions following initial diagnosis, participants often expressed gratitude for early detection and symptom awareness, ii) valued receiving information and education early on, and iii) desired individualized treatment approaches that aligned with their priorities, taking health equity factors into account. As an important subtheme under the third theme, while lifestyle modification was often preferred as the initial approach, many participants also acknowledged pharmacotherapy as a viable option when lifestyle changes had been maximized or could no longer be further optimized. Conclusions This study focuses on the balance between the perceived benefits of early intervention and the risks of overdiagnosis and its consequences. Understanding patient experiences and perspectives in early-stage diabetes highlights the need for shared decision-making and individualized care. Insights will guide the development of tools and resources to help both patients and clinicians shape and navigate informed, patient-centered care. Future work is needed to clarify the evidence for early diagnosis or treatment of people with pre- or mild diabetes to avoid overdiagnosis and overtreatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.028 | 0.021 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.004 | 0.010 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".