Prediabetes

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.