An estimated 16 million Americans have pre-diabetes, on top of the 17 million estimated to have already developed diabetes. Pre-diabetes, a term coined earlier this year as part of an ongoing prevention campaign, describes a condition previously known as impaired glucose tolerance.
Those with the condition have blood glucose levels higher than they should be but are not yet high enough to be classified as diabetes. The higher levels put them at greater risk of developing not only diabetes, but also stroke and heart disease.
While pre-diabetes has been around for years under a different moniker, a growing body of research uncovering its considerable threat encouraged health officials to push for greater awareness and recognition.
"If you tell people that they don't have diabetes yet, they think 'Oh good.' They take that loophole," says Anne Daly, past-president of health care and education for the American Diabetes Association, based in Alexandria, Va. "We don't want people to take that loophole."
Who Is at Risk?
The good news is that with quick intervention a future full of insulin shots can be avoided. Among those at the greatest risk of developing pre-diabetes, and full-blown diabetes, include:
- Those with a family history of diabetes, as well as those who have had high blood sugar while pregnant — a condition known as gestational diabetes.
- Those who belong to minority groups that are disproportionately affected by diabetes, including African Americans, Native Americans, Latinos and Pacific Islanders.
- Those who are overweight or obese.
- Those with high blood pressure or blood fats.
- Those who are sedentary or inactive.
To ward off the the disease, health officials recommended specifically that overweight people over the age of 45 be screened for pre-diabetes.
Keeping Diabetes at Bay
A major message of the government-backed campaign, however, is that diabetes need not be an inevitable conclusion after a pre-diabetes diagnosis.
"Progression to type 2 diabetes can be prevented by lifestyle modification," says Dr. Joann E. Manson, chief of the division of preventive medicine at Brigham and Women's Hospital in Boston, Mass. "Most importantly, lose weight and become physically active."
Medications, such as metformin, may be used in some instances to lower blood sugar. But some experts emphasize the importance of diet and exercise over medical intervention.
"We know that losing weight is effective," says Daly. "In order to create a calorie deficit, which is how you lose weight, you've got to decrease what's coming in the door and increase what's going out the door. You need to work on both sides of that energy equation. You can try to be a couch potato and eat like a bird, but it isn't going to work."
For those who are baffled about getting started on an effective diet and exercise program, Daly recommends consulting a dietitian or other health-care professional for help.
Adds Daly, "If we identify more people with pre-diabetes, it is likely we can prevent heart attacks and strokes by the bucket full, by implementing lifestyle change to decrease medical risk factors that are an accident looking for an place to happen."
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