About 18 million Americans have been diagnosed with diabetes, about 17 million of them have type 2 diabetes.
But there's a new group, experts say, that needs to act, because they have "pre-diabetes." This condition raises a person's risk for developing type 2 diabetes, heart disease and stroke. It is far more common in America than previously believed, according to a new estimate released in April 2004 by the U.S. Department of Health and Human Services (HHS). About 40 percent of U.S. adults ages 40 to 74 -- or 41 million people -- currently have the condition, which is marked by blood glucose levels that are higher than normal but not yet diabetic. Many people with pre-diabetes go on to develop type 2 diabetes within 10 years.
The new estimate is based on a revised, more accurate definition of pre-diabetes made by an international expert committee of the American Diabetes Association (ADA) and published in Diabetes Care in November 2003. Under previous criteria, it had been estimated that 20.1 million in this age group had pre-diabetes.
"Every 25 seconds, someone in America is diagnosed with diabetes," HHS Secretary Tommy G. Thompson says. "These latest numbers show how urgent the problem really is. 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."
"The vast majority of [people with pre-diabetes] are 40 and older," says Frank Vinicor, M.D., M.P.H., diabetes program director at the Centers for Disease Control and Prevention (CDC).
If you have pre-diabetes, you are at 50 percent higher risk for developing heart disease and stroke. According to the ADA, risk factors for pre-diabetes include:
- Being overweight or obese; a body mass index (BMI) of 25 to 29.9 is considered overweight, and a BMI of 30 or higher is obese
- A family history of type 2 diabetes
- Race; being an African American, American Indian, Hispanic American or Asian American
- Low HDL cholesterol and high triglycerides
- High blood pressure
- A history of gestational diabetes
"These are people who are likely to get type 2, or adult onset, diabetes if they don't change the way they live," says Dr. Vinicor. Here are the types of changes experts suggest:
- Weight loss
- Healthy diet
- Moderate exercise
"We've found that losing 8 to 10 pounds can make a difference," Dr. Vinicor says. "People shouldn't think they can't help themselves because they can't lose a large amount at once." You should aim for a BMI of 27 -- ideally, 25 or less.
"To lose weight, maintain loss and live a healthier life, we recommend 150 minutes of exercise a week," Dr. Vinicor says. "That might sound like a lot, but it can be 30 minutes of walking, five times a week."
The goal is to prevent most pre-diabetics from developing diabetes and to ensure that those who develop diabetes do so later in life. "We'd like to see 40- to 45-year-olds and older folks begin to be more thoughtful about this and to ask their family doctor about it," Dr. Vinicor adds.
By the numbers
Two types of tests can determine whether you have pre-diabetes: fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). If your blood sugar level is abnormal with the FPG, you have impaired fasting glucose, according to the ADA. If your blood sugar level is abnormal with the OGTT, you have impaired glucose tolerance.
Here's what overnight fasting blood sugar numbers (with eight hours or more of fasting) mean, according to CDC guidelines backed by the National Institutes of Health, Department of Health and Human Services and American Diabetes Association. Doctors measure blood sugar in milligrams per deciliter (mg/dl):
| Normal | Pre-diabetes | Diabetes |
|---|---|---|
| Below 100 mg/dl | 100-125 mg/dl | 126 mg/dl and above |
Here is what oral glucose tolerance blood sugar numbers mean, according to the ADA:
| Normal | Pre-diabetes | Diabetes |
|---|---|---|
| Below 140 mg/dl | 140-199 mg/dl | 200 mg/dl and above |
About This Article
Publication: Health & You;
Publication Date: Spring 2003;
Author: Jeffrey Bramnick;
Source: American Diabetes Association;
Source URL: http://www.diabetes.org/;
Online Editor: Dianna Sinovic;
Online Medical Reviewer: Cynthia Godsey, M.S.N., F.N.P./C., Gordon Lambert, M.D.;
Date Last Modified: 4/21/04
