The
term prediabetes hasn’t been around long. In fact, it was first used in 2002.
It was introduced by the American Diabetes Association (ADA) and by then–Health
and Human Services Secretary Tommy G. Thompson. There were a number of reasons
for the introduction of this term:
·
The
terms impaired fasting glucose and impaired glucose tolerance were meaningless
to patients and required a lot of explaining.
·
Other
terms, like touch of sugar and borderline diabetes, were generally meaningless.
·
Studies
such as the Diabetes Prevention Program showed that diet and exercise resulting
in a weight loss as little as 5 to 7 percent of someone’s initial weight would
lower the incidence of type 2 diabetes by up to 58 percent.
·
A
broadly understandable term was needed so that patients could know where they
were and where they had to go with respect to diabetes.
These
people stood to benefit from lifestyle modification and other treatments.
Studies
at the time showed that most people with prediabetes would go on to develop
diabetes within ten years unless they made relatively modest changes in diet
and exercise. Therefore, the ADA and Secretary Thompson put together an expert
panel of doctors and other diabetes experts. The panel report stated that
intervention in prediabetes is critical for three reasons:
Just having glucose levels in the prediabetic
range puts a person at a 50
percent greater risk of a heart attack or stroke.
The
development of type 2 diabetes can be delayed or prevented by modest lifestyle
change.
For
many people, modest changes in lifestyle can turn back the clock and return
elevated blood glucose levels to normal.
Along
with the new term, the ADA recommended that physicians begin to screen their
patients for prediabetes at age 45. Screening was especially important for
people who answered yes to these questions:
·
Do
you have a relative with type 2 diabetes or heart disease?
·
Are
you overweight or obese?
·
Do
you have high blood pressure?
·
Do
you have a sedentary lifestyle?
·
Do
you have high levels of triglycerides and/or low levels of HDL cholesterol (both
being types of fats measured in a blood test)?
·
Do
you belong to a higher-risk ethnic group, such as African American, Latino, or
Asian American/Pacific Islander?
·
Do
you have apple-shaped rather than pear-shaped weight distribution? This means
your excess weight is around your stomach rather than your hips.
·
For
women who have had children, did you develop diabetes during the pregnancy or
have a baby who weighed more than 9 pounds at birth?
·
For
women, is there a history of polycystic ovarian syndrome, a condition that may
include lack of periods, infertility, and increased hair on the body?
These
days, if you can answer no to all these questions, you may be from outer space.
So most doctors just screen all people over age 45.
