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Look out for prediabetes

Millions of Americans have prediabetes, but most of them don't know it. Finding and treating the condition can help keep diabetes from developing.

According to the Arizona Department of Health, one-third of people who have diabetes are unaware that they have it. That means an estimated 1 in every 9 people in Arizona has diabetes.1

One of the best reasons to know our risk factors for diabetes is that early action can stop the disease from happening.

Almost all cases of diabetes develop gradually, studies show, and the early stages can be found and treated.

These early stages are known as prediabetes. According to the American Diabetes Association (ADA) and the U.S. Department of Health and Human Services (HHS), screening for and treating this condition could prevent millions of cases of diabetes.

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What's happening

Prediabetes and diabetes are different degrees of the same problem: elevated blood sugar.

Sugar in the bloodstream (glucose) gets too high when the body doesn't have enough of, or can't properly use, a hormone called insulin. Insulin helps transport glucose from the blood to the body's cells, where it can be used as fuel.

One of the first signs that insulin isn't working properly is slightly elevated blood glucose. For years, this condition was known as impaired glucose tolerance or impaired fasting glucose. To mark the significance of the condition and make it easier to recognize and define, the ADA and HHS renamed it prediabetes.

According to an expert panel convened by the ADA and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), prediabetes often turns into diabetes within 10 years.

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Who's at risk?

Prediabetes typically doesn't cause any symptoms, so it's important to be screened if you are at risk. According to the HHS and the ADA, risk factors for prediabetes include:

  • Being age 45 or older
  • Being overweight
  • High blood pressure
  • Low levels of HDL (high density lipoprotein) cholesterol—also known as the "good" cholesterol—and high levels of triglycerides in the blood
  • A family history of diabetes
  • A history of gestational diabetes (diabetes during pregnancy)
  • Having had a baby that weighed more than 9 pounds
  • Belonging to an ethnic group at high risk for diabetes, such as African American, American Indian, Asian American, Hispanic American or Pacific Islander
  • Having polycystic ovary syndrome
If you're older than age 45 but don't have other risk factors, ask your doctor whether you should be screened for prediabetes. People younger than age 45 who are overweight and have at least one other risk factor should ask about starting screening even sooner.

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Screening tests

Prediabetes can be detected with one of three simple tests that measure the body's ability to process glucose.

  • The fasting plasma glucose test measures blood sugar first thing in the morning (requires overnight fasting).
  • The oral glucose tolerance test measures blood sugar first thing in the morning and again two hours after having a glucose-rich drink (requires overnight fasting).
  • The A1C test offers an average reading of your blood sugar over the past two to three months. It does not require fasting.

If your results on one of these tests fall between normal and diabetic, you have prediabetes. You will need to be tested for diabetes every year or two, says the ADA.

If your results are normal, you should be retested for prediabetes every three years.

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Progressive damage

Even slightly elevated blood glucose can damage tissues and organs all over the body. The longer the levels stay high, the more they damage the body, explains Francine R. Kaufman, MD, past president of the ADA.

This progressive damage helps explain why prediabetes increases the risk of heart attack and stroke. If the condition progresses to diabetes, the damage progresses as well. Diabetes increases the risk of heart disease and stroke by as much as four times. It also increases the risk of:

  • Kidney disease
  • Nerve damage
  • Blindness
  • Limb amputations

This very serious disease is becoming more and more common in the United States.

"It's becoming a huge medical issue and a burden to the healthcare system," says Dr. Kaufman.

At the same time, the disease is striking earlier in life. "This used to be a disease of our grandparents," says Dr. Kaufman, but now people are developing the disease at much younger ages.

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Take action

Once it's detected, prediabetes can be stopped. "The Diabetes Prevention Program study showed that we can actually turn back the clock and prevent…diabetes," says Dr. Kaufman.

The study included more than 3,000 people with prediabetes. People who lost 5 to 7 percent of their body weight by cutting back on calories and fat and exercising 30 minutes a day, five days a week (mostly walking), reduced their diabetes risk by 58 percent.

These changes may even bring glucose levels back to normal, eliminating prediabetes.

A limited-time opportunity

Unlike diabetes, prediabetes can be turned around. But you won't know you have it unless you get screened.

If you're at risk, at any age, ask your doctor about getting screened for prediabetes. Small efforts now could save you from a devastating disease later.

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 1. NIH. National Diabetes Statistics, 2007 

reviewed 9/13/2018

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Disclaimer

This information is provided for educational purposes only. Individuals should always consult with their healthcare providers regarding medical care or treatment, as recommendations, services or resources are not a substitute for the advice or recommendation of an individual's physician or healthcare provider. Services or treatment options may not be covered under an individual's particular health plan.