Dealing With Prediabetes

Nearly 24 million people in the United States are estimated to have diabetes. That’s a big number. But it’s not nearly as big as the estimated number who have prediabetes – 57 million.

People who have prediabetes have blood glucose levels that are above normal but that are not high enough to be diagnosed as diabetes. Many people with prediabetes develop Type 2 diabetes within 10 years.

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One of the problems with prediabetes is that there has not been a universally agreed-upon treatment plan for people with the condition. Until now, that is. In the summer of 2008, a consensus conference of the American College of Endocrinology and the American Association of Clinical Endocrinologists released a list of recommendations for comprehensively treating people with prediabetes.

The treatment plan focuses on a number of approaches. The first involves lifestyle changes, and it’s not hard to guess what those are – weight loss, exercise, and improved diet. The task force recommended that people with prediabetes lose from 5% to 10% of their body weight and said that they should get at least 150 minutes of moderate-intensity exercise, such as biking or brisk walking, every week. The panel also recommended following a diet that’s moderate in calories, high in fiber, and possibly limited in carbohydrate.

A second approach is aimed at those who are at particularly high risk. This includes people who have made lifestyle changes but whose blood glucose levels continue to climb, who have signs of cardiovascular disease, or who have nonalcoholic fatty liver disease, polycystic ovary syndrome, or a history of gestational diabetes. For them, medicine should be considered, with drugs to lower cholesterol, blood pressure, and blood glucose levels. (The drugs metformin [brand name Glucophage and others] and acarbose [Precose] were specifically recommended for lowering blood glucose).

Because diabetes tends to run in families, the World Health Organization now recommends that relatives of people with Type 2 diabetes be alert to the disease. A diagnosis of prediabetes is a wake-up call.