By: Jean Johnson for Diabetes1
One in six is great odds if you’re buying a lottery ticket, but when put in terms of how many Americans unknowingly have pre-diabetes, the numbers are cause for concern. That’s why the University of Pennsylvania’s School of Medicine released an Expert Advisory on pre-diabetes late last year.
|The University of Pennsylvania Medical School Expert Advisory suggests you be screened for pre-diabetes if:
You have a known family history of diabetes.
You are African American, Latino, Native American, Asian American or Pacific Islander.
While pregnant you developed gestational diabetes.
You delivered a baby who weighed more than nine pounds.
You have high blood pressure.
You have high blood cholesterol.
You are overweight.
You are over 45.
“Our country is in the middle of a type 2 diabetes epidemic. Right now, if you’re born in the U.S., your risk of developing diabetes is one in three,” Mark Schutta, MD, medical director of the Penn Rodebaugh Diabetes Center said. “If you have pre-diabetes, there’s a 75 percent chance that you will develop diabetes within 30 years.”
There is no cure for diabetes, and it is the fifth deadliest disease in America. So the message is to check early and check often if we are overweight and over age 45, says the American Diabetes Association (ADA). Have our physicians monitor for pre-diabetes and then do our part as patients and be willing to make the lifestyle changes that will restore our bodies to a more even keel.
“Research has shown 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,” the ADA notes. “Recent research has shown that some long term damage to the body, especially the heart and circulation system, may already be occurring during pre-diabetes.”
That’s tough news for the one-sixth of us – 54 million people – who have undetected pre-diabetes. Schutta says the reason for the high numbers is that, like high blood pressure, diabetes often doesn’t causes a single symptom to alert us to its presence. That’s why he urges anyone at risk for diabetes to be screened. See the Take Action box to left for a full listing of risk factors.
“If you knew you had pre-diabetes, you could still prevent getting diabetes through changes in diet and exercise. There are many health benefits to knowing you have pre-diabetes and heading it off. If you wait until you have diabetes, the vascular damage to your body may already be done.”
A Wife’s Thoughts on One Man’s Dilemma
When it comes to our bodies and mortality, intelligence and education are no insulators. That’s what Carolyn Rundanser of Portland, Oregon, speaking under an assumed name to protect the privacy of her husband, Alfred, observed.
Alfred will turn 60 next week and at his physical last spring, his physicians noted that his fasting blood sugar numbers were over the 100 mg/dl normal range. Rundanser says that her husband’s readings were only a touch high, but considering that full-fledged diabetes occurs within a small 26-point range between 100 and 126 mg/dl, even small elevations are considered a warning sign.
“Also, his father had diabetes, so that family history is another reason to be concerned,” Rundanser said. “Still, he’s not really taking it seriously, and I think it was because maybe the doctor wasn’t direct enough. I think that’s what they think when they deal with him, that he’s a smart, well-educated man [he has a master’s degree from the London School of Economics] and so he’ll know how to proceed once he is alerted. But that’s not direct enough for him.
“Part of it’s his sweet tooth. He’s had it from his childhood and was the one that, when he came home from school, would not ask what’s for dinner, but rather what’s for dessert. He’s still that way. If a friend brings something sweet over, he’s very quick to take notice,” said Rundanser with a chuckle.
Rundanser, herself, is quite trim. Her cooking reflects her health consciousness and after she learned about Alfred’s numbers, she has made extra efforts to get appropriate meals on the dinner table.
“He never complains about my cooking,” she said. “Sometimes he’ll wonder how it will taste when I’m adding half turnips to the potatoes to reduce the glycemic level. I try to use this wonderful cookbook called Prescriptive where they try to intensify flavors to deal with people’s love of carbohydrates.”
Alfred Rundanser does carry some extra weight: 10 to 15 pounds that has settled in around his mid-section. His wife thinks, however, that he has trimmed down since he started playing golf this past summer. “He hasn’t used a cart at all and has played twice a week. It’s been great, but I’m not sure how he’ll replace that this winter. I have gotten him over to the yoga studio that I go to for a class each week. And this winter we’ll probably go cross country skiing.
“So things aren’t as bad as they could be, and he is trying in his own way. It’s just that old sweet tooth,” Rundanser mused. “Still he really is in denial and doesn’t think it’s very supportive when I tell him he should lose 10 pounds. But then, I’m not sure if he’s made the connection between his weight and his elevated blood sugar readings. In my view the doctors ought to do more to make sure people understand their situation and not just assume that because someone’s educated in many areas that they are in matters affecting their own health.”
Pre-Diabetes Screening Methods
Most of us are probably familiar with the impaired fasting glucose (IFG) test even if the name doesn’t ring a bell. It’s the one that causes us to make the appointment for our annual physical as early in the morning as possible since we have to fast from dinner the night before until the blood is drawn.
As far as readings, it’s the IFG test that shows normal levels below 100 mg/dl, pre-diabetes between 100 and 126 mg/dl, and full blown diabetes at levels above 126 mg/dl.
There is a second test that physicians can order called an oral glucose tolerance test. For this one you fast eight hours ahead of time and then visit a lab where you drink eight ounces of a sugary liquid. Blood sugar readings are taken before and after the drink to assess the body’s ability to process the sugar.
Even losing a modest amount of weight (five to 10 percent of your total body weight) through watching what you eat and staying active to the tune of 30 minutes a day, five days a week will help, says the ADA. “Don’t worry if you can’t get to your ideal body weight. A loss of just 10 to 15 pounds can make a huge difference.”
To this agenda, the Mayo Clinic adds that eating healthy foods will help the cause. As Carolyn Rundanser is doing to try and help her husband, the Mayo Clinic suggests the following: “Choose foods low in fat and calories. Focus on fruits, vegetables, and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.”
Finally the Mayo Clinic offers hope for those who’ve inherited a genetic predisposition to diabetes: “Even if diabetes runs in your family, healthy lifestyle choices can help prevent pre-diabetes and its progression to type 2 diabetes.”