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Controlling pre-diabetes now can stop diabetes later

» Are you at risk?

» Reversal of fortune

What is diabetes?

Diabetes is a metabolic disorder in which the body fails to properly use or make enough insulin, the hormone needed to convert sugar, starches and other foods into glucose, which the body uses as energy. Without insulin, your body becomes starved for energy, while the glucose builds up in your blood and damages your nerves and blood vessels.

Testing those at risk

Your doctor can use one of two blood tests to determine pre-diabetes:

  • a fasting glucose test measures your blood glucose after you’ve gone overnight without eating. Blood glucose levels between 100 and 125 milligrams per deciliter (mg/dL) indicate impaired fasting glucose or pre-diabetes. A level of 126 mg/dL or higher indicates diabetes.
  • a glucose tolerance test measures your blood glucose after an overnight fast and two hours after drinking a sweet solution provided by the doctor. A level between 140 and 199 mg/dL means you have impaired glucose tolerance or pre-diabetes. A level of 200 mg/dL or higher indicates diabetes.

You’ve no doubt heard about the dangers of type 2 diabetes—caused in part by too little physical activity and too much body weight. Now comes another warning: the risk of developing pre-diabetes, the condition that often precedes the development of full-blown type 2 diabetes, usually within 10 years. Still, pre-diabetes can be a lifesaving wake-up call. By motivating you to act now with the right intervention, you can lower your glucose levels, turn back the clock and prevent diabetes altogether.

Are you at risk?

An estimated 60 million people have pre-diabetes, though many are unaware they have the condition since it usually shows no symptoms. But damage to your heart and circulatory system may already be under way. If you are overweight and over age 45, you may be at risk and should ask your doctor about a pre-diabetes screening. If you are overweight but younger than 45, your doctor may advise testing if you have any of these diabetes risk factors:

  • high blood pressure
  • low HDL, or “good” cholesterol, and high triglycerides
  • a family history of diabetes
  • a history of gestational diabetes or of giving birth to a baby weighing more than 9 pounds
  • being of African-American, Hispanic/Latino, Native American or Asian/Pacific Islander descent

Reversal of fortune

Lifestyle changes such as losing weight and exercising are key to avoiding diabetes and can reduce your risk for the disease by 58 percent. Even modest health improvements—losing as little as 5 percent to 10 percent of your body weight and getting 30 minutes of daily physical activity such as walking briskly or biking—may be enough to thwart the disease. Experts also recommend limiting the fat in your diet to no more than 30 percent of your total calories.

Currently, no drug has been approved specifically for prediabetes by the Food and Drug Administration. Trials involving existing diabetes drugs to control blood sugar, such as metformin and acarbose, proved each was effective at delaying or reducing the risk for diabetes but not as effective as lifestyle measures.

The incentive should be obvious. Diabetes is a leading factor in heart disease, stroke, blindness, amputations and kidney failure. Diabetes cannot be cured, and management to ward off complications involves lifelong daily vigilance of diet and medication. Experts hope that sounding the alarm on pre-diabetes will prompt the millions at risk to get control of their blood sugar, their weight and their health.

© 2014 Dowden Health Media