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41 Million Americans at Risk of Diabetes

New standard doubles the old estimate

THURSDAY, April 29, 2004 (HealthDayNews) -- Forty-one million Americans have blood sugar levels high enough to put them at risk of developing diabetes -- more than twice the previous estimate.

The new number means two of every five adults aged 40 to 74 is now considered to have pre-diabetes, the U.S. Department of Health and Human Services reported Thursday.

"These latest numbers show how urgent the problem really is," said Health and Human Services Secretary Tommy Thompson, the Associated Press reported. "We need to help Americans take steps to prevent diabetes or we will risk being overwhelmed by the health and economic consequences of an ever-growing diabetes epidemic."

About 18 million Americans have diabetes, with 1.3 million new cases diagnosed every year. Most have type 2 diabetes, which develops as the body gradually loses its ability to metabolize blood sugar. Diabetes is a leading cause of heart disease, blindness, kidney failure and amputations, killing more than 200,000 Americans every year.

Pre-diabetes "puts someone at risk not only of diabetes but also of heart attack and stroke," said Linda S. Geiss, chief of diabetes surveillance at the U.S. Centers for Disease Control and Prevention.

There are no agreed-upon estimates of the percentage of people with pre-diabetes who will develop the full-blown disease, Geiss said. But it is known that "taking preventive measures can return a pre-diabetic person to normal," she said. Those measures include proper nutrition and exercise.

Pre-diabetes can be diagnosed by the "impaired glucose tolerance" test, which measures blood sugar levels before eating anything in the morning. Until last November, a level below 110 milligrams of glucose per deciliter of blood was described as normal. The new guideline lowers the bar, so a reading of 100 or higher classifies someone as pre-diabetic.

The new estimate comes from applying that standard to data from the latest National Health and Nutrition Examination Survey, Geiss said.

The American Diabetes Association is using the new guideline to call for what it says are relatively simple lifestyle changes to reduce the risk of developing diabetes.

"The biggest drivers include the high prevalence of obesity, which in turn is driven by exercise habits and diet habits," said Dr. Gene Barrett, president of the association and professor of medicine at the University of Virginia.

Adults should be doing the minimum amount of exercise recommended by many health organizations -- 30 minutes of moderate activity at least three days a week, Barrett said. They also should avoid "high-calorie, high-density foods," he said.

Parents also should be looking after their children, with an eye not only toward having them exercise regularly but also "the easy availability of soft drinks and fast foods in school meal programs," Barrett said.

Losing just 5 percent of body weight -- 10 pounds for a 200-pound adult -- can move someone out of the pre-diabetic state into better health, he said.

Unless those steps are taken, "you will wind up with a lot of people in trouble," Barrett said.

More information

Get a thorough description of pre-diabetes and what can be one about it from the American Diabetes Association. For more on diabetes, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Gene Barrett, M.D., professor, medicine, University of Virginia, Charlottesville, and president, American Diabetes Association; Linda S. Geiss, director, diabetes surveillance, U.S. Centers for Disease Control and Prevention, Atlanta; April 29, 2004, statement from the U.S. Department of Health and Human Services
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