Pre-diabetes: Do you have it?


Published: Wednesday, January 17, 2007 at 6:01 a.m.
Last Modified: Wednesday, January 17, 2007 at 12:00 a.m.

When Martha Buess, a sales executive in Kansas, was told she was close to becoming a diabetic, her doctor gave her two choices: Change your lifestyle or develop diabetes and take drugs for the rest of your life.

Facts

WARNING SIGNS

Look out for the following indications:

  • Increased thirst
  • Increased hunger
  • Fatigue
  • Increased urination, especially at night
  • Weight loss
  • Blurred vision
  • Sores that do not heal

RISK FACTORS
Are you at rise for developing pre-diabetes or Type 2 diabetes? The National Diabetes Education Program offers this checklist. Are you or do you have?
  • Age 45 or older
  • Overweight
  • Members of a high-risk ethnic population
  • Family history of diabetes
  • An inactive lifestyle
  • High blood pressure: 140/90 mm/Hg or higher
  • HDL cholesterol less than 35 mg/dL or a triglyceride level 250 mg/dL or higher
  • Diabetes that developed during pregnancy, called gestational diabetes, or given birth to a baby weighing more than 9 pounds
  • Polycystic ovary syndrome, a metabolic disorder that affects the female reproductive system
  • Acanthosis nigricans, or dark, thickened skin around neck or armpits
  • History of disease of the blood vessels to the heart, brain, or legs
  • Impaired fasting glucose or impaired glucose tolerance on previous testing

PREVENTION
  • Maintain normal weight
  • Exercise regularly
  • Eat more fresh fruit, vegetables, nuts and whole grains
  • Keep meat, poultry and fish servings down to 3 ounces, about the size of a deck of cards
  • Eat three sensible meals a day
  • Limit fried foods
  • Keep cholesterol level normal
  • Keep blood pressure below 130/80

Reliable sources for information on pre-diabetes and diabetes are:
  • National Diabetes Education Program
    www.ndep.nih.gov (800) 438-5383.
  • National Diabetes Information Clearinghouse- www.diabetes.niddk.nih.gov
    (800) 860-8747.
  • The American Diabetes Association- www.diabetes.org
    This site includes a risk test.

Buess chose to take control.

She attended classes, worked with a dietitian, changed her eating habits and began a regimen of long walks.

Not easy, she admits. She battles weight and struggles with food choices every day.

Normal blood glucose is 70 to 100 milligrams per deciliter — or mg/dL — for most people. Now her blood sugars is below 100 and she feels energetic.

This tale exemplifies a battle against a national epidemic — diabetes. Nearly every American is at risk because so many are overweight.

Nearly 21 million Americans have diabetes. Plus, the National Institutes of Health estimates that a third of those with diabetes don't even know they have it.

An estimated 41 million — more people than live in the entire state of California — have pre-diabetes.

Pre-diabetes is serious.

But the disease is preventable.

Many people with pre-diabetes develop Type 2 diabetes within 10 years. Also, pre-diabetes substantially raises the risk of a heart attack or stroke even if Type 2 diabetes does not develop, said Catherine Cowie of the National Institute of Diabetes and Digestive and Kidney Diseases.

Cowie was a lead researcher on a landmark study published in June on diabetes prevention by the National Institutes of Health and others. The study showed that onset of Type 2 diabetes can be prevented or delayed by losing 5 percent to 7 percent of body weight.

Dietitians recommend eating 450 fewer calories a day to lose weight.

Being overweight and inactive increases the changes of developing diabetes. Exercise helps the body use insulin.

Excess weight can keep the body from making and using insulin the way it should. The study looked at more than 2,000 individuals who were overweight and higher than normal levels of blood glucose, a condition that signals pre-diabetes.

Half of those in the study were people of color, since many are especially susceptible to the disease.

One test group ate healthier and exercised for 30 minutes at least five days a week, usually walking. The other was treated with the diabetic drug metformin.

The group that modified their lifestyle reduced their risk by 58 percent. Individuals 60 years and older were most affected; they reduced their risk by 71 percent.

The drug-treated group reduced their risk by 31 percent.

Type 2 diabetes, formerly called adult-onset or non-insulin dependent, is the most common form of the disease. It usually begins when fat, liver and muscle cells do not use insulin properly.

The body breaks all food into a type of sugar called glucose. Glucose travels through the blood stream to cells. Cells use insulin to convert blood glucose into energy.

Type 1, usually diagnosed in childhood, means the pancreas does not make insulin. The Type 1 diabetic must take insulin in the form of shots or a pump.

A third type is called gestational diabetes, developed in some women during the last stages of pregnancy. According to NIH research, women who have had gestational diabetes are more likely to develop Type 2 diabetes.

Individuals with depression are at greater risk for developing diabetes, according to the National Institutes of Mental Health. Stress also affects blood sugar levels.

Who should be tested? The NIH recommends anyone over 45 years old and overweight. Ask for a fasting blood glucose test or an oral glucose tolerance test.

In pre-diabetes, blood glucose is 100 to 125 mg/dL in a fasting test and 140-199 mg/dL in an oral tolerance test.

Unchecked diabetes can lead to a myriad of health horrors including stroke, kidney disease, blindness and amputation due to nervous system problems.

In a culture of desk jockeys, couch potatoes and mile-long to-do lists, changing lifestyles is daunting if not impossible.

To help, health professionals offer these suggestions:

· Make a plan.

· Decide precisely what you will do and when you will do it.

· Think about what will prevent you from reaching your goal.

· Surround yourself with family and friends who will support and encourage you.

· Decide how you will reward yourself when you have carried out your plan.

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