Destined for Diabetes?

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Destined for Diabetes?

Published on: May 12, 2004

By Halperin

People with type 2 diabetes are often surprised by their diagnosis.

But the truth is that this kind of diabetes tends to develop

gradually. It starts with a condition known as pre-diabetes.

According to a new estimate from the Department of Health and Human

Services (HHS), 41 million Americans are living with pre-diabetes,

which is about 20 million more people than previous thought.

HHS based their estimate on a new definition of pre-diabetes

developed by the American Diabetes Association last year. Experts say

it's important for Americans to know that 40 percent of US adults

from ages 40 to 74 have pre-diabetes because of the risks associated

with this condition.

" In the past, pre-diabetes was thought as 'a touch of diabetes,' but

not anymore, " says Astrid Almodovar, MD, an assistant clinical

professor of family medicine at University of Medicine and Dentistry

of New Jersey with a private family practice in Newark. " Today, even

if you don't progress to diabetes, pre-diabetes indicates a risk of

cardiovascular disease and stroke. "

Knowing Your Numbers

According to the American Diabetes Association, pre-diabetes is

defined as a condition in which blood glucose (blood sugar) levels

are higher than normal but not at a diabetic level. Doctors use two

tests to identify people with pre-diabetes: impaired glucose

tolerance (IGT) tests and impaired fasting glucose (IFG) tests. An

IGT test checks your blood sugar two hours after a meal. If your

blood sugar level is between 140 mg/dL and 199 mg/dL that indicates

you have pre-diabetes. Because some external factors, such as

exercise, may affect an IGT test, more specific information can be

gathered from an IFG test, which is given in the morning before

breakfast. Someone with pre-diabetes will have blood sugar levels

between 100 and 125 mg/dL in the IFG test.

Some lab reports may focus on reporting a " positive " or " negative "

after either test, but it's important to find out your number and not

just the range. " Being close to 100 is still a warning sign, " Dr.

Almodovar says. Knowing your blood sugar level will help you set your

goal: to lower your count to a safe number. It's important to get

your blood sugar below the pre-diabetic levels because pre-diabetes

can lead to heart disease and stroke.

Are There Other Warning Signs?

Certain groups of people are at increased risk for both pre-diabetes

and diabetes. For example, anyone over 60 years old and anyone with

family history of diabetes is at risk. Diabetes appears very

prominently in people with certain ethnic backgrounds: African

American, Hispanic, Latino, American Indian, Alaskan native, Asian

and Pacific Islander. Your body may also alert you to test for pre-

diabetes with other clues that, collectively, suggest you're at

increased risk. These include blood pressure over 140/90 mm Hg; HDL

(good cholesterol) levels below 40 mg/dL for men or below 50 mg/dL

for women; or triglyceride levels above 250 mg/dL.

Are You Destined for Diabetes?

Many people with pre-diabetes develop type 2 diabetes within a

decade. But making lifestyle changes can help keep pre-diabetes from

escalating to diabetes. The Diabetes Prevention Program (DDP), which

is sponsored by the National Institutes of Health, recommends taking

steps to lower body weight by 5 to 7 percent because being overweight

can put you at risk. This can be achieved by calorie cutting, fat

intake reduction and exercise.

People with pre-diabetes should also consider a walking program. Just

adding 30 to 40 minutes of walking, five days a week, can increase

your chances of avoiding diabetes by up to 58 percent. " Everyone has

48 half-hours in their day, " Dr. Almodovar says. " If you dedicate

just one of these 48 half-hours to promoting health, you're keeping

diabetes at bay. "