Pre-Diabetes

Are you one of the estimated 54 million people in this country who have pre-diabetes?

If you have pre-diabetes, you are at high risk of developing type 2 diabetes and also are at increased risk of developing heart disease. Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. Those with pre-diabetes are at increased risk of developing type 2 diabetes within a decade unless they adopt a healthier lifestyle that includes weight loss and more physical activity.

First, let’s define what “pre-diabetes” is and is not. Diabetes is defined as having a fasting plasma blood glucose level of 126 mg/dl or greater on two separate occasions. If diabetes symptoms exist and you have a casual blood glucose taken at any time that is equal to or greater than 200 mg/dl, and a second test shows the same high blood glucose level, then you have diabetes.

In general, people who have a fasting plasma blood glucose in the 100-125 mg/dl range are defined as having impaired fasting glucose. If your doctor gives you an oral glucose tolerance test, and at two-hours your blood glucose is 140-199 mg/dl, you have “impaired glucose tolerance”. Either of these is medical terminology for what your doctor is probably referring to when he says you have “pre-diabetes.” Be sure to ask your doctor what your exact blood sugar test results are when he tells you that you have “pre-diabetes.” Some physicians are not as familiar as they should be with the new national guidelines for diagnosing diabetes. They may be telling you that you have pre-diabetes, when in fact you have actual diabetes.

Among those who should be screened for pre-diabetes include overweight adults age 45 and older and those under age 45 who are overweight and who have one or more of the following risk factors:

are habitually physically inactive
have previously been identified as having IFG (impaired fasting glucose) or IGT (impaired glucose tolerance)
have a family history of diabetes
are members of certain ethnic groups (including Asian American, African-American, Hispanic American, and Native American)
have had gestational diabetes or have given birth to a child weighing more than 9 pounds
have elevated blood pressure
have an HDL cholesterol level (the “good” cholesterol) of 35 mg/dl or lower and/or triglyceride level of 250 mg/dl or higher
have polycystic ovary syndrome
have a history of vascular disease

That all said, if you have pre-diabetes diabetes, what should you do? Results of a large U.S. nationwide study released in August 2001 showed that even if you are at risk for developing type 2 diabetes, you can reduce your risk by 58% through sustained modest weight loss and increased moderate-intensity physical activity, such as walking 30 minutes a day.

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