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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High blood pressure is twice as likely to strike a person with diabetes than a person without diabetes.
Left untreated, high blood pressure can lead to increased risk for heart disease and stroke.
In fact, a person with diabetes and high blood pressure is four times as likely to develop heart disease than someone who does not have either of the conditions.
About 73 percent of adults with diabetes have blood pressure greater than or equal to 130/80 mm Hg or use prescription medications for hypertension.
Blood pressure is the force of the blood pushing against the artery walls. Each time the heart beats, it is pumping blood into these arteries - resulting in the highest blood pressure when the heart contracts and is pumping the blood.
High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack).
With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.
Two numbers are used to measure blood pressure. The higher number, the systolic pressure, refers to the pressure inside the artery when the heart contracts and is pumping the blood through the body.
The lower number, the diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood.
Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of your blood.
According to the National Heart, Lung, and Blood Institute (NHLBI), high blood pressure for adults is defined as 140 mm Hg or greater systolic pressure and
The new NHLBI guidelines now define normal blood pressure as less than 120 mm Hg systolic pressure and less than 80 mm Hg diastolic pressure.
Always consult your physician for more information.