Healthy Lifestyle Can Keep Pre-Diabetes under Control
Experts say lifestyle changes, coupled with a reduction in
heart disease risks, will go a long way toward preventing pre-diabetes from
progressing to the full-blown disease.
Pre-diabetes occurs when blood sugar levels are elevated,
but not quite to the point defined as diabetes. More than 56 million Americans
currently suffer from pre-diabetes, according to the
Centers for Disease Control and Prevention (CDC).
"Diabetes has become the major problem in the United
States," says Dr. Harold Lebovitz, at the State University of New York Health
Sciences.
Dr. Lebovitz notes that diabetes is the main cause of
kidney failure and most blindness in adults, and causes about 60 percent of
cardiovascular diseases.
"The issue is, do you wait until patients really develop
these catastrophic complications?" says Dr. Lebovitz. "Last year, it cost $170
billion in direct and indirect costs to take care of people with diabetes."
The growing epidemic of diabetes in the US will continue to
cost more, unless something is done to halt it, notes Dr. Lebovitz.
"Diabetes starts at an earlier stage, called pre-diabetes,"
he says. "The question arises, should you wait for pre-diabetic patients to
develop diabetes and the complications, or should you take a preventive
approach?"
The American Association of Clinical
Endocrinologists (AACE) is pressing for aggressive action to keep
pre-diabetes from progressing to full-blown diabetes.
The first step involves lifestyle changes, such as diet and
exercise.
"It will cost a lot of money to develop lifestyle programs,
but in the long run we will save trillions of dollars in health care," says Dr.
Lebovitz.
Many people question whether pre-diabetes is actually a
disease, notes Dr. Lebovitz.
"The important message is that pre-diabetes is not
something people don't have problems with," he says. "Sure, they don't have any
problems when they're 30, but when they're 50, they've had their heart attack
and now they have an ulcer on the foot."
In addition to lifestyle changes, the
AACE thinks that pre-diabetes needs to be treated
more aggressively.
Since there are no medication therapies approved by the
US Food and Drug Administration (FDA) for treating
pre-diabetes, the AACE suggests another way to get
them: Reduce the number at which blood sugar levels define diabetes.
That would make current medications available to people who
are now classified as pre-diabetic.
In addition, those who cannot modify their cardiovascular
risk by lifestyle changes need to be treated for high blood pressure, high
cholesterol, and should have medications to control blood sugar levels.
"The data show that there is a spectrum of severity, with
the most severely affected approaching the risks of people with diagnosed type 2
diabetes," says Dr. Daniel Einhorn, vice-president of AACE.
"In these highest-risk individuals, who represent a minority, pharmacologic
strategies may be appropriate if intensive lifestyle therapies fail.”
Dr. Einhorn says, “Regardless, all individuals at risk for
diabetes should be aware of the level of their risk factors and be prepared to
take action."
Always consult your physician for more information.
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