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Do You Have Pre-Diabetes?

New government figures say 16 million Americans have high blood sugar

WEDNESDAY, March 27, 2002 (HealthDayNews) -- For each one of the 16 million Americans who have Type II diabetes, there's another one at risk of joining their ranks, the government said today.

"Pre-diabetes," which is a new term to describe an elevated but not technically diabetic blood sugar reading, is not only a stepping stone to full-blown diabetes, it also increases the risk of heart attacks, strokes and heart disease by 50 percent. New government figures released today estimate that 16 million Americans over the age of 40 are pre-diabetic.

"The good news is if you have pre-diabetes, you can do something about it," said Tommy Thompson, Secretary of Health and Human Services (HHS), in a statement today. "We want people to know that pre-diabetes is a serious condition that can be reversed or alleviated with modest changes in their daily routines -- such as eating fewer calories and walking regularly for exercise."

The number of people with either form of diabetes -- Type I or, more commonly, Type II -- has reached 17 million, an 8 percent increase over earlier estimates, Thompson said. Of those, 5.9 million don't know they have the disease.

At least 90 percent of American diabetics have Type II, or adult-onset, form, which is closely linked to obesity. As the number of overweight Americans has climbed sharply in recent decades, so, too, has the number of diabetics.

People with pre-diabetes generally develop full diabetes within a decade of showing abnormal blood glucose. If unchecked, diabetes can cause blindness, kidney failure, heart attacks, strokes, and a laundry list of other serious complications. Its toll: 180,000 deaths a year, many of which are preventable.

HHS, the American Diabetes Association, and other diabetes experts announced the new data at a press conference where they issued new guidelines for doctors to stave off the progression of the disease.

Chief among these is routine screening for pre-diabetes for all overweight people who are over age 45, either with a fasting blood glucose test or the oral glucose tolerance test. The tests measure how well a person's body is processing blood sugar, and reflect sensitivity to the hormone insulin. Insulin helps cells convert glucose into energy.

The guidelines also call on doctors to screen for pre-diabetes in seriously overweight people under 45 if they have the following risk factors: a family history of diabetes, high blood pressure, and abnormal blood fats. Women with a history of pregnancy-related, or gestational, diabetes, and those who delivered a baby nine pounds or heavier, are also considered at risk, as are members of racial minority groups, including Latinos, African Americans, American Indians, Asian Americans and Pacific Islanders.

"This new recommendation gives physicians added incentive to screen their middle-aged, overweight patients for both Type II diabetes and pre-diabetes," Dr. Francine Kaufman, president-elect of the American Diabetes Association, said in a statement. "If you have pre-diabetes, you need to know it, so you can learn about the high risk of getting diabetes and the steps you can take to prevent it. If you already have diabetes, you need to be treated early to prevent complications."

Dr. Frank Hu, a Harvard University nutrition expert, said the concept of pre-diabetes "is important, in that pre-diabetes, if not intervened, can be easily changed to diabetes."

Studies show "very clearly," he added, that people on the brink of diabetes can be brought back into sound health through diet, regular exercise, and other lifestyle changes.

Diet and exercise alterations that lead to a 5 percent to 7 percent drop in weight can cut the risk of Type II diabetes by almost 60 percent, health officials said.

What To Do

To learn more about diabetes, visit the American Diabetes Association, the Centers for Disease Control and Prevention, or the Joslin Diabetes Center.

For more on obesity and how to control your weight, check out the National Institutes of Health.

SOURCES: Frank Hu, M.D., Ph.D., assistant professor of nutrition and cardiovascular disease, department of nutrition, Harvard School of Public Health, Boston; March 27, 2002, statements from HHS Secretary Tommy Thompson and Francine Kaufman, M.D., president-elect, American Diabetes Association
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