Oct 20, 2014 8:00 AM

Author: Office of Public Affairs

If you’re older than 45, you should be screened for diabetes and prediabetes.

That’s a proposed recommendation from the US Preventive Services Task Force. The American Diabetes Association and the American Medical Association support the stance.

Previously, routine screening focused only on people with risk factors for diabetes, such as obesity and family history, and women who had gestational diabetes or polycystic ovarian syndrome.

But diabetes is an epidemic in this country. According to the Centers for Disease Control and Prevention, 29.1 million Americans have the condition, but nearly 28 percent, or 8.1 million, of them are undiagnosed because they do not recognize the symptoms or are ignoring them.

Timothy E. Graham, MD, medical director of the Utah Diabetes and Endocrinology Center at University of Utah, says the screening recommendation represents an important step toward early detection. But there is more work to be done, he believes.

Screening for prediabetes—defined by a blood sugar level that’s elevated but not yet categorized as diabetes—can reduce the number of people who develop the full-blown disease if lifestyle changes are made. Recent clinical trials found that people with prediabetes had a 58 percent reduced risk of developing diabetes over the next several years through diet changes and exercise. Certain medications may also be effective. 

“By the time people get prediabetes, they have been living with metabolic dysfunction for years—sometimes decades—and the elevated blood sugars that herald prediabetes occur in the later stages of the disease process,” Graham says. 

“We have embraced prediabetes, but we need to start embracing ‘pre-prediabetes’ and identify people at risk years before they develop elevated blood sugars when the disease process can be reversed more easily.” 

Graham says individuals who are obese or have signs of cardiovascular disease would benefit from lifestyle intervention. “We can effect change through a combination of lifestyle changes and medication, and we can do this even before people develop signs of abnormal blood sugar levels.”

diabetes prediabetes

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