You can delay or stop diabetes if you catch it before it truly begins. Doctors call this early stage prediabetes. The condition exists when your blood sugar levels rise higher than normal, yet remain lower than those found in diabetes. Studies show that effective treatments can prevent the progression of prediabetes to diabetes. What’s the catch? You won’t receive this care if you don’t even know you have the problem.
Here’s where new guidelines from the American Diabetes Association enter. Based on the updated advice, many more people should get tested for prediabetes than in the past. And some folks should begin receiving the tests well before middle age, the association says.
Check out these questions and answers to learn how the latest advice applies to you.
What’s the big deal?
Scientists estimate that an unprecedented 54 million Americans have prediabetes. Without treatment, most people with the condition will go on to develop type 2 diabetes mellitus within 10 years, studies show. Full-blown diabetes causes abnormally high blood sugar levels that may lead to serious health problems.
Even before then, though, people with prediabetes face many of the same health risks as diabetics. For example, people with prediabetes have 1 1/2 times greater risk of heart disease and stroke compared while diabetics have two to four times increased risk.
Other health hazards of both conditions include blindness, kidney failure, nerve damage and infections leading to leg amputations.
Who needs screening?
The American Diabetes Association recommends a blood test for all adults starting no later than age 45. Formerly, the advice was only to consider the test at that age, especially in overweight individuals. If the results are normal, testing should be repeated at least every three years.
Testing should also be considered for adults of all ages who are overweight and have at least one other risk factor. The advice clearly pertains to young men and women at risk for diabetes. Factors that increase risk include physical inactivity, high blood pressure, abnormal cholesterol, a family history of diabetes or belonging to a racial minority group.
Past diabetes during a pregnancy, or giving birth to a baby weighing more than 9 pounds are additional factors that can put you at risk.
How is it diagnosed?
A fasting blood glucose level between 100 and 125 milligrams is currently classified as prediabetic. Alternatively, a glucose tolerance test can be performed. During this test, a two-hour blood glucose value between 140 and 199 signals prediabetes. Blood levels below this amount are considered normal while higher levels are indicative of diabetes.
If your test shows diabetes, have it confirmed with a repeat test, the diabetes association says. And don’t rely on hemoglobin A1C tests for diagnosis.
What treatments prevent diabetes?
The association recommends therapeutic lifestyle changes for people with prediabetes. If you’re overweight, a weight loss of just 5- to 10 percent can improve the condition, research shows. So can engaging in moderate physical activity for 30 minutes at least five days a week.
A large study followed a group of prediabetics who made these changes. After an average followup of three years, participants achieved nearly a 60 percent reduction in diabetes risk compared to a 30 percent reduction in those on medication.
And what if a drug is prescribed? Metformin is the only one advised for prevention, the diabetes association says.
For more information: American Diabetes Association, www.diabetes.org.
Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider.
&Copy; 2008 Elizabeth S. Smoots
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