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Prediabetes - A New Term for an Old Condition

November is Diabetes Awareness Month
Prediabetes - A New Term for an Old Condition

In the United States more than 17 million people are likely to suffer from diabetes in the next 10 years. These people have prediabetes, which means that their above-normal blood sugar levels put them at a high risk of developing type 2 diabetes. A combination of overweight, inactivity and genetics is the principle cause of this condition. What is most surprising is that most people with prediabetes are not aware that they have it. Catching the condition before it turns into full-blown diabetes can be a lifesaver.

Type 2 diabetes results in the loss of our bodies to respond to insulin or to no longer make enough of it. Insulin helps the body use glucose as fuel, and without it sugar builds up in the bloodstream. If blood sugar levels are not kept in check, diabetes can increase a person's risk of heart disease and cause damage to the eyes, kidneys, nerves and other body tissues. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes

Prediabetes was previously called impaired fasting glucose, but diabetes experts introduced the new term last year. According to the American Diabetes Association (ADA), this new term is not only more consumer-friendly, but it does more to convey the urgency of the condition. Prediabetes is like a warning light that signals danger ahead, but it is in your power to do something about it.

WHO SHOULD BE SCREENED FOR PREDIABETES?

According to the ADA, if you answer yes to one of the following questions, you would benefit from testing for prediabetes. If you answer yes to more than one, you may be at risk.

  • Do you have a relative with type 2 diabetes or heart disease?

  • Are you overweight or obese?

  • Are you 45 or older?

  • Do you have high blood pressure?

  • Do you belong to a higher-risk ethnic group, including African American, Latino and Asian American/Pacific Islander?

  • Do you have "apple-shaped" rather than "pear-shaped weight distribution. This means that your excess weight collects around your stomach rather than your hips? To check, divide your waist measurement by your hip circumference. For women, this result should be less than 0.8; for men less than 0.9. You should also be evaluated if you are female and your waist is above 35 inches, or male and above 40 inches.

  • For women who have had children, did you develop diabetes during pregnancy or have a baby who weighed more than nine pounds at birth.

WHAT IS PREDIABETES?

In October, the ADA broadened its definition of prediabetes to include anyone with fasting blood glucose levels of 100 milligrams per deciliter of blood. The previous cutoff point had been 110 milligrams.

There is no one easy test to identify prediabetes. In addition to the fasting glucose levels doctors look at the results of several different tests to make a diagnosis. They include:

  • Triglycerides more than 150 milligrams per deciliter.

  • High-density lipoprotein, or "good" cholesterol less than 40 milligrams per deciliter for men, 50 milligrams for women.

  • Blood pressure above 130/85 mm Hg

The recently completed Diabetes Prevention Program (DPP) study conclusively showed that people with pre-diabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range.

While the DPP also showed that some medications may delay the development of diabetes, diet and exercise worked better. Just 30 minutes a day of moderate physical activity, coupled with a 5-10% reduction in body weight, produced a 58% reduction in diabetes.

The American Diabetes Association is developing materials that will help people understand their risks for pre-diabetes and what they can do to halt the progression to diabetes.

For more information on prediabetes and type 2 diabetes, check the ADA's web site at www.diabetes.org

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