Far too few Americans with prediabetes know they have the condition, according to a new report from the Centers for Disease Control and Prevention (CDC). In 2010, about one in three U.S. adults 20 and older (about 79 million people) had prediabetes, which can lead to full-blown type 2 diabetes, but only about 11% were aware of it. Treating prediabetes early with dietary changes, weight loss, and increased physical activity can help prevent or delay the onset of type 2 diabetes.
With prediabetes, a person has a blood glucose level (the major blood sugar) that is higher than normal but not high enough for a diagnosis of diabetes. According to the CDC and the American Diabetes Association (ADA), without lifestyle changes such as weight loss and exercise, 15% to 30% of people with prediabetes—which does not result in any symptoms that would alert someone to the condition—will develop type 2 diabetes within 5 to 10 years of the onset of prediabetes.
With type 2 diabetes, a person's body does not produce enough insulin or isn't able to make use of the insulin the body does produce. People need insulin to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches, releasing glucose, the basic energy fuel for the body's cells. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of being transported into cells, it can lead to very serious complications such as heart attacks, strokes, kidney failure, blindness, and poor blood circulation leading to the need for limb amputations.
According to the CDC, risk factors for both prediabetes and type 2 diabetes include:
- Being over age 45
- Being overweight or obese
- Having a family history of diabetes
- Having an African American, Hispanic/Latino, American Indian, Asian American, or Pacific Islander racial or ethnic background
- Having a history of diabetes while pregnant (gestational diabetes)
- Having given birth to a baby weighing 9 pounds or more
- Being physically active less than 3 times a week
Two blood tests are used to determine if someone has prediabetes—a fasting glucose test and an A1C test to screen for high blood glucose levels, also known as hyperglycemia:
- Fasting glucose: This test measures the level of glucose in the blood after an 8-12 hour fast. The test is often done as part of a regular physical, when someone has symptoms suggesting high or low blood glucose levels or during pregnancy and requires a blood sample drawn from a vein in the arm or a skin prick. Non-diabetic value is less than 100 mg/dL.
- A1c: This test measures the average amount of glucose in the blood over the last 2 to 3 months and is used to diagnose prediabetes and diabetes, to monitor the progression of diabetes, and to help make treatment decisions. Non-diabetic value is 5.7% or less.
Having the tests, getting the results, and then reviewing them with your doctor are all critical. According to the ADA, while prediabetes increases your risk for diabetes and its complications, making changes in diet and exercise can reduce your risk of progressing to full-blown diabetes.
ADA recommendations include:
- If testing shows that your blood glucose levels are in the normal range, get rechecked every 3 years, or more often if your doctor recommends that.
- If testing determines that you do have prediabetes, you should be checked for type 2 diabetes every 1 to 2 years.
- If you have prediabetes, you can reduce your risk of progressing to type 2 diabetes by almost 60% by losing 7% of your body weight (that's about 15 pounds if you weigh 200 pounds) and by getting moderate exercise, such as brisk walking just 30 minutes a day, 5 days a week.
- For some people, taking medication for prediabetes can return blood glucose levels to normal.
"Because the vast majority of persons with prediabetes are unaware of their condition, identification and improved awareness of prediabetes are critical first steps to encourage those with prediabetes to make healthy lifestyle changes or to enroll in evidence-based, lifestyle-change programs aimed at preventing type 2 diabetes," say the study authors.
The National Diabetes Education Program, a partnership of the National Institutes of Health and CDC, has resources that can help reduce the risk of type 2 diabetes, including "Small Steps. Big Rewards. Your Game Plan to Prevent Type 2 Diabetes" and "Just One Step," which has information on making important lifestyle changes.
Check your risk for prediabetes today by taking the CDC's "Am I at Risk?" quiz.
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(March 22, 2013) Adler, C. Most People with Prediabetes Are Unaware of Their Condition. JournalWatch. Available online at http://firstwatch.jwatch.org/cgi/content/full/2013/322/3 through http://firstwatch.jwatch.org. Accessed April 15, 2013.
(March 22, 2013) Centers for Disease Control and Prevention. Awareness of Prediabetes — United States, 2005–2010. MMWR 62(11); 209-212. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6211a4.htm through http://www.cdc.gov. Accessed April 15, 2013.
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(October 9, 2012) Centers for Disease Control and Prevention. Prediabetes: Am I At Risk? Available online at http://www.cdc.gov/diabetes/prevention/prediabetes.htm through http://www.cdc.gov. Accessed April 16, 2013.
(©2013) American Diabetes Association. Top Five Things You Need to Know About Prediabetes. Available online at http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/pre-diabetes-faqs.html through http://www.diabetes.org. Accessed April 21, 2013.
(©2013) American Diabetes Association. Prediabetes Facts. Available online at http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/pre-diabetes-faqs.html through http://www.diabetes.org. Accessed April 15, 2013.