Prediabetes in practice: Examining the stratified medicalization of diabetes prevention

Abstract

Drawing on multi-sited ethnographic data examining the diagnosis and treatment of prediabetes in three socioeconomically distinct clinics, this paper illuminates how this medicalized approach to diabetes prevention amplifies inequities in care across lines of class-based and racialized difference. While all three clinics adhere to a standard definition of the predisease, prediabetes is performed in markedly different ways across these clinics, patterned by their diverse institutional structures and assumptions about their patient populations. This has unequal consequences for patients' understandings of their bodies and their health futures, and patients diagnosed with prediabetes are subject to distinct forms of discipline, empowerment, and even abandonment.