Could you have prediabetes and not know? If you are older than 45, overweight and inactive, the answer is yes, experts say.
According to the Centers for Disease Control and Prevention, 1 out of 3 Americans has prediabetes, meaning their blood sugar (glucose) level is high but not high enough for a type 2 diabetes diagnosis. As many as 40 percent of Americans are believed to have prediabetes, says Timothy Graham, MD, director of the University of Utah's Diabetes and Heart Disease Prevention Program.
That doesn't mean they've dodged a bullet by coming under the glucose wire.
"Even if you don't ever develop diabetes, having prediabetes gives you nearly the same two- to threefold increased risk for heart disease and stroke that diabetes imparts," Graham says. "I like to call prediabetes the 'epidemic within the epidemic.' For every patient with a case of diabetes that shows up in clinic, there are four or five patients walking around in the background with prediabetes, and most of them have no idea they have the condition."
It's estimated that 79 million people have prediabetes in the U.S. Most will develop full-blown type 2 diabetes within 10 years of diagnosis. The condition also increases the risk of heart disease and stroke.
In 2013, 7.2 percent of adults in Utah, or more than 130,000 people, said they have diabetes, according to America's Health Rankings.
Graham says Utah's residents are not unlike the rest of the nation.
"Obesity and inactivity are on the rise in Utah, as they are elsewhere in the U.S. and the developed world," he says. "Obesity and inactivity lead to insulin resistance, which is a major risk factor that predisposes individuals to develop prediabetes."
Prediabetes Risk Factors
Who's at risk for prediabetes? Anyone older than 45, especially if inactive and overweight, should be tested, experts say. Other risk factors include:
- A close family member, such as a parent or sibling, has diabetes.
- You are of African-American, American-Indian, Latin-American or Asian/Pacific Islander descent.
- Your blood pressure, cholesterol or triglyceride levels are high.
- You are a woman who had diabetes while pregnant or who has polycystic ovary syndrome.
Even with a diagnosis of prediabetes, you may not automatically develop type 2 diabetes. The American Diabetes Association says you can lower your risk by:
- Losing weight—shoot for 7 percent of your total body weight. That's 15 pounds if you weigh 200 pounds.
- Exercise—30 minutes a day, five days a week. Moderate exercise, like a brisk walk, is fine.
Medications like metformin also may be a good next step, Graham says.
But the goal is getting blood sugar levels down as soon as possible.
"There is exciting data from the long-term outcomes study of the U.S. Diabetes Prevention Program research suggesting that people with prediabetes who can normalize their blood glucose regulation even for a few months may be able to cut their risk of diabetes in half," Graham says. "A 50 percent risk reduction is huge. So, we need to be aggressive about getting our patients with prediabetes back to normal, so to speak."