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June 15th, 2011
03:32 PM ET

Where can I find information about pre-diabetes?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Asked by Nicole from Sacramento, California

I just heard I am glucose intolerant (or pre-diabetic) and diabetes runs in my family. However, whenever I try to find information about pre-diabetes, I only get diabetes type 2 information. Are there any helpful websites with good information?

Expert answer

You ask an incredibly important question. Pre-diabetes and diabetes have become significant problems in the U.S. and Western world.

Diabetic diseases are a preventable epidemic that have become a significant cost to society in terms of health care and lost productivity. It is estimated that 79 million Americans have pre-diabetes, and most do not know they have it. Furthermore, it is believed that 26 million Americans have diabetes and one-fourth are unaware that they have it.

Type 2 diabetes is a condition in which the patient has high blood sugars, resistance to the action of insulin, and some have impairment of insulin secretion. It is sometimes called adult onset diabetes, but this name has lost favor as more and more children are diagnosed with it.

Risk factors for type 2 diabetes include obesity, a sedentary lifestyle and a close relative with the disease. Certain racial/ethnic groups seem to be at higher risk, especially African-Americans, Native Americans and Hispanics. Type 1 or juvenile diabetes is a different disease.

Pre-diabetes is a commonly used phrase for people who have a glucose problem that is not severe enough to fulfill the definition of type 2 diabetes. People with pre-diabetes usually progress to diabetes over time. Indeed, some studies show that 25% progress to diabetes within three years of a diagnosis of pre-diabetes.

The American Diabetes Association has defined factors that indicate an increased risk for the development of diabetes. People with one of these factors is commonly considered to have pre-diabetes. They include:

• A blood glucose of 100 to 125 mg/dL after an eight- to 10-hour fast. This is referred to as impaired fasting glucose.

• A post-prandial blood glucose of 140 to 199 mg/dl. The patient is given 75 mg of glucose by mouth, and the blood glucose level is measured two hours later. This is defined as an impaired glucose tolerance.

• A hemoglobin A1C of 5.7 to 6.4%. Hemoglobin A1C is a common blood test that measures what the patient's blood sugars have been over the previous three months.

The patient with pre-diabetes often also has high blood pressure and high cholesterol and/or high triglycerides. This combination is referred to as "the metabolic syndrome."

The combination of diabetes, high blood pressure and lipid problems increases risk for heart disease, vascular disease, stroke, nerve damage, kidney disease and blindness.

Pre-diabetes and type 2 diabetes have a substantial genetic component, but their development can be influenced, both positively and negatively, by environmental and behavioral factors. For most, there is clear benefit to diet modification and weight reduction.

For those who do not have these diseases, diet modification and weight reduction can be preventive. For those who already have these diseases, diet and exercise can decrease their severity.

Nearly a dozen studies show that moderate regular physical activity, even without weight loss, can help lower the risk of progression to diabetes. This activity can be brisk walking.

Studies show that weight loss, while difficult to achieve, is very helpful. Most who are successful participate in support programs. A person with pre-diabetes should be under the care of a physician. The physician will encourage diet modification, regular exercise and weight loss in addition to treating high blood pressure and lipid problems, if needed. The physician may also prescribe a drug, metformin, which in some studies slows the progression to diabetes.

The increasing incidence of this disease is directly related to the global epidemic of obesity. The U.S. Centers for Disease Control and Prevention has published studies showing that nearly 50% of Americans are overweight and an additional 25% are obese; this compared with less than 40% being overweight or obese in the 1970s.

Obesity and diabetes rates are rising in the Europe and Asia, but not to the extent they are in the U.S. Do see a doctor if you suspect you have pre-diabetes or diabetes.

Common symptoms are fatigue, excessive thirst, excessive urination, blurred vision and wounds that will not heal quickly. Many have no symptoms early in the disease.

It is important for people with this disease to understand it. A wonderful source of accurate and up-to-date information on pre-diabetes and diabetes is the American Diabetes Association at http://www.diabetes.org/.


soundoff (16 Responses)
  1. Hunter

    Good Calories, Bad Calories by Gary Taubes. Read it.

    June 15, 2011 at 16:43 | Report abuse | Reply
    • Mike

      Yes, it you want to read cherry-picked data that only includes outdated, long ago disproved studies that supports the "researcher's" nonsensical hypothesis. Ignoring the effect of ASP on fat synthesis is asinine.

      June 15, 2011 at 20:23 | Report abuse |
    • Hunter

      From what I've read ASP research has been inconclusive so far as no one has been able to prove without a doubt what exactly it's function is in humans.

      And I will defend the book Good Calories, Bad Calories as it does not contain "cherry-picked data" but instead tries to present the whole story to the reader and explain how nutritional recommendations to the general public have instead been "cherry picked" throughout history. And "long ago disproved studies"? It really sounds like you've never even read the book. It's an excellent source of information for the average person who wants to learn more about diabetes. Sure it's about 3 years old now but this is a good start.

      June 15, 2011 at 23:48 | Report abuse |
  2. Nicole Rasmussen

    I would like to correct you in your statement that Diabetic diseases are preventable. There is a vast difference between Type-1 and Type-2 Diabetes. Because of the large number of overweight and unhealthy people acquiring Type-2 Diabetes, Type-1 is being overshadowed. Type-1 Diabetics cannot prevent getting the disease, nor is it in any way their fault for acquiring it. Living with this disease has made it very clear to me people's perception of the disease have become highly inaccurate. I think when talking about diabetes you should always specify Type-1 or Type-2, as they are not the same disease and should not be treated the same. I plead with anyone so called "pre-diabetic", please take your warning seriously. Coming from someone with no choice, I say you are lucky to have one.

    June 15, 2011 at 18:13 | Report abuse | Reply
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    The food chemicals break the gut(insulin) and this is the cause of the diabetes and obesity crisis

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    June 15, 2011 at 21:12 | Report abuse | Reply
    • wayne

      Or the high consumption of grains and starchy food is the bad guy. Carbs tend to overwork the mechanics that keep our blood sugar at the correct level. Type two Diabetes would go away if people gave up the catrbs.

      June 16, 2011 at 05:26 | Report abuse |
    • Jim

      Wayne is absolutely correct. Carbs are the bad guys. For more about type 2 diabetes, including information on carbs and many other well-researched subjects on type 2 diabetes, go to bloodsugar101.com. It's completely free. (I'm not advertising). Each article includes links to the actual research done and being done. You will find many helpful suggestions on what you can do to prevent complications from this disease. The more you know about type 2 diabetes the more you can maintain your health. I wish you all well.

      June 16, 2011 at 07:30 | Report abuse |
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  6. Big Daddy

    I think the issue is that doctors do not know enough about diabetes and pretend they do. If you are pre-diabetic you ARE diabetic. There is no such thing as pre diabetes, either you are or not. This is part of the problem. As soon as you have any issue with blood sugar levels you must change your eating habits. It's already too late, but it can be controlled with diet and exercise. In the USA we are given horrible food choices, especially in big cities. The expense of eating right is impossible for the average person to do. Yet the government keeps us from getting this more healthy food and tells us to lose weight....thank you US Government. There is NO such thing as pre-diabetes.

    June 16, 2011 at 06:54 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.