Health Feature Articles
Pre-Diabetes: A risk factor for heart disease and stroke
Gail Carlson, MPH Ph.D., State Health Education Specialist, University of Missouri Extension
Jane hadn’t been feeling well and frequent trips to
the doctor over a period of months didn’t give her any
answers. Jane’s sister, Betty, was worried that it might
be diabetes. Betty had diabetes and Jane seemed to have
some of the symptoms. She also had a number of risk
factors. Diabetes ran in the family. Jane was overweight
and not very active and she was getting older, if 60 is
old. But the tests the doctor did came back negative.
Six months passed, the symptoms seemed to come and go
and yet there was no good explanation for why Jane
didn’t feel well. One day when Jane was visiting, Betty
encouraged Jane to test her blood sugar. Jane agreed and
used Betty’s monitor. Much to Jane’s surprise the
reading was high. Not really high, but higher than it
should be. At her next doctor’s visit, Jane’s provider
retested her and the test came back positive. Jane was
told she had pre-diabetes. She was also told that by
changing her diet and exercising, she might be able to
delay the onset of type 2 diabetes.
In most cases, people will develop pre-diabetes before
they develop type 2 diabetes. Other names for
pre-diabetes are impaired glucose tolerance and impaired
fasting glucose. These are the names of two tests
commonly used to determine if someone has pre-diabetes
or diabetes. When someone has pre-diabetes, their blood
glucose levels are higher than normal but not high
enough to be diagnosed with diabetes. Most people with
pre-diabetes develop type 2 diabetes within 10 years.
However, the onset of diabetes can be prevented or
delayed. The Diabetes Prevention Program Study,
completed in 2002, showed that the onset of diabetes can
be delayed by a slight weight loss, 7 percent to 10
percent of current body weight, and 30 minutes of
moderate physical activity at least five days a week.
These modest lifestyle changes were found to work better
than medication in delaying diabetes, although the
medication did work.
If you have pre-diabetes, you can and should do
something about it. Pre-diabetes is not just an early
warning sign for diabetes. Individuals with pre-diabetes
have a 1.5 times greater risk of cardiovascular disease
(heart disease and stroke) compared to people with
normal glucose levels.
People who are at risk of diabetes are also at risk
of pre-diabetes. You should be tested for pre-diabetes
if:
- You are age 45 and older and overweight.
- You are younger than age 45, overweight and have even one of the following risk factors:
-
High blood pressure;
-
Low HDL cholesterol and high triglycerides;
-
Family history of diabetes;
-
History of gestational diabetes (diabetes that occurs during pregnancy);
-
Gave birth to a baby weighing more than 9 pounds; or
-
Being a member of a racial or ethnic group, such as African-American or Hispanic, that places you at greater risk.
If you are aged 45 and older, with a normal weight, ask
your health care provider if he or she recommends
testing. People with pre-diabetes may have the same
symptoms of people with diabetes, such as unusual
thirst, a frequent need to go to the bathroom, blurred
vision, and/or a feeling of being tired most of the time
but for no apparent reason. But many people with
pre-diabetes and type 2 diabetes don’t have symptoms, or
the symptoms develop so gradually people don’t recognize
them. That is why it is important to ask your provider
about being tested, particularly if you have a number of
the risk factors mentioned earlier.
By the way, here’s the rest of Jane’s story. Jane
continued regular visits to her provider. She took
better care of herself. She lost weight and exercised
regularly. She began to educate herself about diabetes.
She brought her blood sugar levels back to within a
normal range. She also understands that she will need to
eat healthfully and remain physically active to keep it
that way.
For more information on pre-diabetes and diabetes,
call 1-800-DIABETES, or visit the following Web sites:
National Diabetes Education Program,
http://ndep.nih.gov/;
American Diabetes Association,
http://www.diabetes.org/main/ .
References:
American Diabetes Association (2002) The Prevention or
Delay of Type 2 Diabetes. Diabetes Care 25:742-749
American Diabetes Association. Pre Diabetes. http://www.diabetes.org/pre-diabetes.jsp
American Diabetes Association. Total Prevalence of
Diabetes & Pre-diabetes.
http://www.diabetes.org/diabetes-statistics/prevalence.jsp
Centers for Disease Control and Prevention. (2005)
National Diabetes Fact Sheet: General Information and
National Estimates on Diabetes in the United States,
2005. Atlanta, GA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention,
2005.
http://ndep.nih.gov/diabetes/pubs/2005_National_Diabetes_Fact_Sheet.pdf
National Diabetes Education Program (2005) Your Guide to Diabetes: Type 1 and Type 2. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.diabetes.niddk.nih.gov/dm/pubs/type1and2/index.htm
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Last Updated 04/25/2008
