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Pre-diabetes: You Can Do Something About It

A diagnosis of pre-diabetes may sound like a precursor to the inevitable. But in reality, health care providers and researchers say, people with pre-diabetes have a good chance of preventing diabetes — as long as the diagnosis urges them to cut fat from their diet, exercise more, and lose weight.

According to the American Diabetes Association (ADA), research shows that "if you take action to manage your blood glucose when you have pre-diabetes, you can delay or prevent Type 2 diabetes from ever developing." Government reports and recommendations continue to stress the importance of making lifestyle improvements that reduce the likelihood of getting diabetes.

"The good news is if you have pre-diabetes, you can do something about it," said Tommy G. Thompson when he was secretary of Health and Human Services (HHS).

The federally funded Diabetes Prevention Program (DPP) found that people with pre-diabetes could reduce their risk of getting Type 2 diabetes by 58 percent with the help of physical activity of, on average, 30 minutes a day and a loss of 5 to 7 percent of their body weight. The study made it clear that exercising and losing weight can have a dramatic effect on the numbers of new diabetes cases, researchers working on the DPP said.

And that's good news, especially considering the prevalence of pre-diabetes cases. According to the ADA, at least 20.1 million people in the United States ages 40 to 74, have pre-diabetes. That equals 21.1 percent of the US population. Many don't know it and likely will develop Type 2 diabetes without ever having the chance to ward it off.

That is why it is important for people at risk for pre-diabetes — also called impaired glucose tolerance or impaired fasting glucose — to get tested. Doctors typically perform one of two tests: a fasting plasma glucose test or an oral glucose tolerance test. Both tests can determine whether the patient's glucose level is normal or if it indicates pre-diabetes or diabetes.

People with pre-diabetes have a fasting blood sugar of 100 mg/dL, compared with a fasting blood sugar of 126 mg/dL or higher for people with diabetes.

The government DPP panel suggested that physicians screen overweight people ages 45 and older for pre-diabetes during regular office visits. Other people at risk include those with a family history of diabetes, high blood pressure, a history of gestational diabetes, women who have given birth to a baby weighing more than 9 pounds, high triglycerides, and belonging to certain minority groups. African Americans, American Indians, Latinos, and Asian American/Pacific Islanders are at increased risk for diabetes.

Some drugs also have been found to have an effect on reducing the risk among people with pre-diabetes of developing Type 2 diabetes. The DPP study found that treatment with the oral diabetes drug metformin reduces diabetes risk by 31 percent, but the panel did not recommend routine use of prescription drugs as an initial treatment for drug therapy.

Adapted by Editorial Staff, February, 2005
Last update, July 2008

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