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UC Davis Health System

UC Davis Health System

Are you a (silent) part of the diabetes epidemic?

One in four American adults has prediabetes

couple walking their dog
One in four American adults has “prediabetes” — high blood-sugar levels that signal looming, full-fledged diabetes. Exercising 30 minutes a day and losing a few pounds can help to halt or reverse the process.

By Sanyukta Pawar, M.D. 

Chances are you’ve seen it in the headlines. Thanks to obesity and lack of physical activity, diabetes has become a health problem of epidemic proportions in the United States.

What you may not know is that an estimated one in four American adults over age 20 already has “prediabetes” — high blood-sugar levels that signal a collision course with full-blown diabetes and its potentially deadly complications. 

Dr. Pawar practices internal medicine at Rocklin's Placer Center for Health.

Fortunately, relatively modest lifestyle changes can slow or reverse prediabetes and prevent you from developing diabetes proper. Even losing as little as 10 pounds can make a huge difference.

Prediabetes and diabetes

The American Diabetes Association recommends testing for prediabetes and diabetes in adults without symptoms who are overweight or obese and have one or more additional risk factors, such as:
  • physical inactivity
  • parent or sibling with diabetes
  • family background is African American, Asian American, Hispanic/Latino, Alaska Native, American Indian or Pacific Islander
  • gestational diabetes or giving birth to a >9 pound baby
  • high blood pressure
  • low HDL or “good” cholesterol
  • high triglyceride levels
  • polycystic ovary syndrome
  • impaired fasting glucose or glucose tolerance in previous testing
  • other conditions associated with insulin resistance, such as severe obesity or acanthosis nigricans
  • cardiovascular disease

If test results are normal, testing should be repeated at least every 3 years. In those without these risk factors, testing should begin at age 45.

Diabetes is a disease in which blood glucose, or sugar, levels are too high. More than nine in 10 cases are type 2 or “adult-onset” diabetes, the kind linked to excess body weight and physical inactivity.

In type 2 diabetes, your body does not make or make good use of insulin, a hormone that helps glucose enter your cells to give them energy. Without enough insulin, the glucose stays in your blood and can lead to serious and often life-threatening cardiovascular, kidney or eye problems. 

Dr. Pawar"A prediabetes diagnosis can be used as warning to take control and change your health and habits before it’s too late." 
— Sanyukta Pawar

According to the CDC, the risk of death among people with diabetes is about twice that of people without diabetes of a similar age, and people with diabetes lose 10-15 years of life on average. Diabetes is also the leading cause of new cases of blindness, kidney failure and nontraumatic amputations of the legs and feet.

Prediabetes involves blood-glucose levels that are higher than normal, but not high enough to be classified as formal diabetes. You may hear a physician refer to elevated or prediabetic blood glucose levels as “impaired glucose tolerance” or “impaired fasting glucose.”

According to the National Diabetes Information Clearinghouse, studies have shown that most people with prediabetes develop type 2 diabetes within 10 years — unless they lose weight and change their diet and physical activity.

Like diabetics, prediabetics also have increased risk of heart disease and stroke. And according to the American Diabetes Association, recent research has shown that some long-term damage to the body — especially the heart and circulatory system — may already occur during prediabetes.

Symptoms, tests and risk factors

When they do occur, physical symptoms of prediabetes can include:

  • Unusual thirst;
  • A frequent desire to urinate;
  • Blurred vision; and/or
  • A feeling of being tired most of the time for no apparent reason.

But like type 2 diabetes itself, people with prediabetes often do not experience noticeable symptoms at all. Physicians usually diagnose the condition through one or more blood tests that gauge long-term blood sugar levels, fasting blood sugar, and/or your body’s response after drinking a sweet liquid. 

Ditching prediabetes

Self-test

To take the American Diabetes Association risk test for diabetes, visit www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test

The good news about a prediabetes diagnosis is that it can be used as warning sign, allowing you to take control of and change your health and habits before it’s too late.

While several drugs have been shown to reduce diabetes risk to varying degrees, none are approved by the U.S. Food and Drug Administration for treating prediabetes or preventing diabetes.

However, relatively modest lifestyle changes can delay or prevent the onset of type 2 diabetes in prediabetics — and even restore normal blood-glucose levels.

Achieving a 5 to 7 percent weight loss and logging 150 weekly minutes of moderate physical activity can reduce the onset of type 2 diabetes in prediabetics by nearly 60 percent.

That doesn’t have to mean fitting into your high-school jeans — for many people, a 5 to 7 percent weight loss can be as little as 10 pounds or less. And 150 minutes of exercise can translate into a just a brisk half-hour walk taken five days a week. Simple!

If current trends continue, one in three Americans will develop diabetes sometime in their lifetime. With a few adjustments, many prediabetics can avoid being one of them.