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    Does pre-diabetes really exist?

    7 August 2014

    Pre-diabetes is an artificial category with virtually zero clinical relevance,’ said an American professor in the Times. A friend of mine has even been told by the vet that her little cat is in a pre-diabetic condition, being a little over the norm on the feline body mass index. I began to think that pre-diabetes was like the countryman’s hills: if you can see them it’s going to rain. (If you can’t, it’s raining — you’ve got diabetes.) But then I did something sensible. I looked up the term in the dictionary.

    It is no neologism. The first example in the OED comes from more than 100 years ago. ‘At present we know little of any pre-diabetic stage of diabetes,’ a expert wrote in the Lancet in 1907, ‘and it is not possible to foretell whether a given case of pancreatitis will or will not go on to diabetes.’ No doubt more is known today, and in any case, sitting around eating eccles cakes all day reduced the odds against.

    In the 19th century the medical world took on pre- terms like recruiting offices in 1914. Pre-malignant came along in 1884 and pre-epileptic in 1903, but earlier in the 19th century pre- was also employed to signify place, not time, as in pre-dorsal, a position anterior to the dorsal part (which may be on the tongue, which has a dorsal feature as familiar as the Dorsoduro of Venice).

    In its frequent combination with personal names (pre-Darwinianpre-Christianpre-Shakespearian) there is a notion that pre- was found preferable to ante- because the latter sounded like anti-, and there’s a great difference between being innocently ante-Freudian and resolutely anti-FreudianPre- could also have stronger implications than the merely chronological. ‘I reverence — indeed almost idolise,’ wrote William Rossetti in 1850, ‘what I have seen of the Pre-Raphael painters.’ But it was his circle that became known as Pre-Raphaelites, not the painters who had actually been active before Raphael.

    The pre- terms that are particularly infuriating imply no more than what has to be done anyway: pre-cookedpre-washedpre-wrappedPre-order is a pet hate. What does it add to order? But it has been around since 1937. It doesn’t do to prejudge these things.

    This piece first appeared in Dot Wordsworth’s Mind Your Language column in The Spectator, dated 9 August 2014