Government urges prevention to ward off full-blown epidemicThe Associated
Press
Updated: 2:33 p.m. ET April 29, 2004WASHINGTON - Millions more Americans
than previously thought have signs of what could later turn into diabetes,
the government says

Doubling previous figures, the government estimates that 41 million
Americans have pre-diabetes blood sugar high enough to dramatically
increase their risk of getting the full-blown disease.

The figures released Wednesday are significantly higher than previous
estimates because doctors have changed the criteria for diagnosing the
condition after research showed they were missing too many at-risk patients.

These latest numbers show how urgent the problem really is, said Health
and Human Services Secretary Tommy Thompson, who was announcing the new
estimates at a federal health meeting Thursday in Baltimore.

Should you be evaluated for prediabetes?

Take the following self-inventory to determine if you would benefit from
testing for prediabetes. If you answer yes to any of these questions,
particularly to more than one, you may be at risk.

Do you have a relative with type 2 diabetes or heart disease?
Are you overweight or obese?
Are you 45 or older?
Do you have high blood pressure?
Do you belong to a higher-risk ethnic group, including African American,
Latino and Asian American/Pacific Islander?
Do you have "apple-shaped" rather than "pear-shaped" weight distribution,
meaning your excess weight collects around your belly rather than your hips?
To check, divide your waist measurement by your hip circumference. For
women, this figure should be less than .8, for men less than .9. A quick
check that doesn't involve math: you should be evaluated if you're male and
your waist is above 40 inches, or female and above 35 inches.
For women who've had children, did you develop diabetes during pregnancy
or have a baby who weighed more than nine pounds at birth?

We need to help Americans take steps to prevent diabetes or we will risk
being overwhelmed by the health and economic consequences of an ever-growing
diabetes epidemic.

The good news is that modest diet and exercise can delay, if not prevent,
the onset of diabetes in many pre-diabetics.

But most of these people have no idea theyre at risk, said Dr. Francine
Kaufman, past president of the American Diabetes Association.

Some 18 million Americans have full-blown diabetes, a leading cause of
blindness, kidney failure, amputations and heart disease that claims 180,000
U.S. lives a year.

FACT FILE Diabetes
Almost 17 million Americans have diabetes, a disease that affects the body's
ability to manage glucose, or blood sugar.

Type 1 diabetes is an autoimmune disease that destroys the body's ability to
produce insulin, a hormone that helps the body stash various nutrients in
cells. This form of the disease, which most often develops in childhood,
accounts for 5 to 10 percent of cases.

Type 2 diabetes usually develops in adulthood and is caused by either the
body's inability to make enough, or to effectively use, insulin. This form
of diabetes accounts for 90 to 95 percent of cases.
Women can develop a form of type 2 diabetes during pregnancy called
gestational diabetes. Approximately 40 percent of women with gestational
diabetes who are obese before pregnancy develop type 2 diabetes within four
years.

Frequent urination

Constant sensation of thirst

Unexplained weight loss

Extreme hunger

Sudden vision changes

Tingling or numbness in the hands or feet

Extreme fatigue

Slow healing sores

Frequent infections

People are more likely to develop diabetes if they are obese or have a
family history of the disorder. And as age increases, so does the risk of
diabetes. In addition, certain groups are at increased risk for diabetes,
including blacks, Hispanics and Native Americans.

Some cases cannot be prevented. However, maintaining a healthy weight and
exercising regularly may help protect against the development of type 2
diabetes in many people.

The American Diabetes Association recommends blood glucose screenings
beginning at age 45, or younger if someone has a family history of diabetes,
is obese or has other risk factors.
At least a third of people with type 2 diabetes go untreated because they
dont know they have the condition. Many of these people will be diagnosed
with diabetes only after they have developed serious complications, such as
heart attack, kidney disease or impaired eyesight.

People with type 1 diabetes must take daily insulin shots to live and are
advised to carefully watch their diets.
People with type 2 diabetes may be able to control their blood sugar through
diet and exercise. Others may need to take oral diabetes medicines to lower
their blood glucose levels. If this doesn't work, insulin may be necessary.

Some people are born with it, but the vast majority have Type 2 diabetes, an
illness that develops, often in middle age, when their bodies lose the
ability to turn blood sugar into energy. Obesity, an increasing problem in
the United States, is associated with diabetes.

The loss in ability to turn blood sugar into energy is very gradual, and it
can be measured by blood tests. Glucose levels that are above normal but not
yet in the diabetic range signal pre-diabetes and a change in what one
test considers normal prompted the governments new increased estimates.

New definition of 'normal'
Doctors once thought blood sugar levels below 110 milligrams per deciliter
as measured by the impaired fasting glucose test given before eating
anything in the morning were normal. But the American Diabetes Association
in November changed the definition of normal to below 100 milligrams
meaning anyone with a fasting glucose between 100 and 125 milligrams is now
classified pre-diabetic.

Test yourself

That seems like a small change. But a lot of people are in that 100 to 110
range, data that conclude about 40 percent of people ages 40 to 74 are
pre-diabetic, explained Dr. Frank Vinicor, diabetes chief for the Centers
for Disease Control and Prevention.

Changing the pre-diabetes cut-off isnt an arbitrary decision, Vinicor
said. Its based on emerging science from the last two to three years,
that found the risk of glucose-spurred heart disease began rising at lower
levels than once thought.

Cut-offs for a second test where blood sugar levels are measured two hours
after a glucose-rich drink remain unchanged. Levels between 140 and 199
milligrams are considered pre-diabetic in that test.

Doctors typically repeat the test every three years if results are normal,
but may test people with multiple risk factors more often.

If the test diagnoses pre-diabetes, there are proven ways to lower the risk
of full-blown illness, Vinicor stressed, such as walking 30 minutes a day,
five days a week, and losing 5 percent to 7 percent of body weight.

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