Issued Quarterly

June 2004

H&S 3:2

06/04 

ABSTRACT

PRE-DIABETES

Prepared by:  Youmasu J. Siewe, Ph.D., MPH

OCES Specialist for Public Health Education

333 HES, Oklahoma State University

Cooperative Extension Service

Stillwater, OK 74078

(405) 744-6824 or (405) 744-9929

SOURCES:  Archives of Internal Medicine, May 10, 2004: Volume 164 pages 934-942,http://www.cdc.gov/diabetes/pubs

PRE-DIABETES is a new term for a condition that people get before being diagnosed with regular type-2 diabetes.  Many people with pre-diabetes go on to develop type 2 diabetes within 10 years. Impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) is characteristic of pre-diabetes: What are IGT and IFG?

·         IFG is a condition in which the blood sugar level is high (100 to 125 milligrams per deciliter or mg/dL) after an overnight fast but not high enough to be classified as diabetes.

·         IGT is a condition in which the blood sugar level is high (140 to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not high enough to be classified as diabetes

By identifying individuals with pre-diabetes, preventive measures such as losing weight, becoming physically active and eating a healthy diet can be initiated to prevent diabetes and other serious health problems. Type-2 diabetes is strongly associated with overweight and obesity.  By losing 5 to 7 percent of body weight through diet and increased physical activity individuals can prevent or delay pre-diabetes from progressing to type-2 diabetes

Results from the Diabetes Prevention Program (DPP) indicated that adults at risk for developing type-2 diabetes could prevent or delay the disease with lifestyle changes in diet and exercise. The Diabetes Prevention Program found that diet and exercise resulting in a 5-7 percent weight loss lowered the incidence of type 2 diabetes by 58 percent. Weight loss can be achieved by:

• Reducing fat and calories in their diet
• Engaging in physical exercising such as walking at least 30 minutes a day for about five or more days a week.

Based on the DPP results, the American Diabetes Association (ADA) recommends that all overweight people 45 years of age or younger with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) should be classified as having pre-diabetes and considered potential candidates for diabetes prevention interventions.  Overweight is defined as having a body mass index greater than or equal to 25 kg/m².

To determine how many adults in the United States could potentially benefit from these interventions, researchers at the Centers for Disease Control and Prevention (CDC) have released the following data about the number of adults with pre-diabetes.

• About one-fourth (22.6%) of overweight adults aged 45-74 years had pre-diabetes.
• An additional estimated 6.5 million people with undiagnosed diabetes would be detected in identifying pre-diabetes.
• Among adults with pre-diabetes, the prevalence of cardiovascular (heart) disease risk factors was high:
  • 94.9% had dyslipidemia (high blood cholesterol);
  • 56.5% had hypertension (high blood pressure);
  • 13.9% had microalbuminuria, a protein found in blood plasma and urine that can signal kidney disease; and
  • 16.6% were current smokers.

Risk factors for pre-diabetes adults include the following:

·     Young adults 45 years of age or younger and significantly overweight.

·     Family history of diabetes

·     Low HDL cholesterol and high triglycerides

·     High blood pressure

·     History of diabetes during pregnancy or birth to a baby weighing 9 pounds or more.

·     Belong to a minority group (African-Americans, American Indians, Hispanic Americans/Latinos, and Asian American/ Pacific Islanders are at increased risk for type 2 diabetes).