A leading San Antonio physician is drawing attention to an early method of identifying people at risk for developing Type 2 diabetes years before the disease is diagnosed.
Dr. Ralph DeFronzo, professor of medicine and chief of the Diabetes Division at UT Health San Antonio, and deputy director of University Health’s Texas Diabetes Institute, is advancing the idea of what he calls “pre-prediabetes.” His research suggests that traditional tests may miss people already on the path toward type 2 diabetes.
His findings were published in July 2025 in The Journal of Clinical and Applied Research and Education: Diabetes Care. It challenges conventional thinking about the onset of Type 2 diabetes.
Currently, doctors diagnose prediabetes based on fasting glucose or a two-hour glucose test after a sugar drink. But DeFronzo and colleagues point to another measure: the one-hour glucose level. Their studies show that people who appear “normal” under standard tests but record a higher-than-expected one-hour glucose reading are more likely to progress to prediabetes and eventually diabetes.
DeFronzo has long argued for earlier and more aggressive treatment. Clinical trials have shown that starting with a combination of medications rather than waiting until glucose levels worsen can preserve the body’s ability to control blood sugar for longer.
Type 2 diabetes is a defining public-health challenge in San Antonio. About 15% of adults are living with diabetes, a higher share than Texas and the nation, according to a July 2025 analysis by University Health’s Institute for Public Health.
Physicians warn that one in three San Antonians has prediabetes, and about one in six already has full blown Type 2, foreshadowing cardiovascular, kidney and vision complications without sustained prevention and treatment.
Guest:
Dr. Ralph DeFronzo, professor of medicine and chief of the Diabetes Division at UT Health San Antonio, and deputy director of University Health’s Texas Diabetes Institute.
"The Source" is a live call-in program airing Mondays through Thursdays from 12-1 p.m. Leave a message before the program at (210) 615-8982. During the live show, call 833-877-8255, email thesource@tpr.org.
This interview will be recorded live Wednesday, September 24, 2025.
