Thursday, 9 December 2010

Millions May Not Know They Have Prediabetes

Millions May Not Know They Have Prediabetes

Since the mid-1990s, John Sammon has been trying to change his lifestyle.

Eating healthier food. Exercising more. Seeing a doctor regularly.

And in the end, it was those doctor visits that led to a diagnosis of prediabetes, a medical issue that millions of Americans do not even know they have.

The 68-year-old Dunmore resident underwent double bypass surgery in 1994 and his doctor, Anthony Perry, M.D., ordered blood tests every three months to monitor the effect medications were having on his body.

About 18 months ago, Dr. Perry noticed that Mr. Sammon's blood-sugar levels were higher than normal. Like many prediabetics, he had no symptoms that his blood-sugar was abnormal. And even after the diagnosis, Mr. Sammon said he detected almost no changes in the way he felt.

"I didn't think it was serious; that if I made some changes, it would go away," Mr. Sammon said about the prediabetes diagnosis. "But it didn't work out like that."

Even with immediate treatment, coupled with the healthy habits Mr. Sammon was working on, he soon developed Type 2 diabetes.

About 57 million Americans suffer from prediabetes, according to the Centers for Disease Control and Prevention. And with few symptoms, many do not know they have it, said Susan Vrablic, coordinator of the diabetes program at Pocono Medical Center.

"Most people find out through routine blood work," Ms. Vrablic said. "It's largely a silent condition."

Prediabetics will have a fasting blood sugar between 100 and 126 milligrams of glucose per deciliter, or mg/dL, of blood, Dr. Perry said. Less than 100 mg/dL is considered normal and more than 126 mg/dL is considered diabetic, he added.

Left unchecked, prediabetes will often develop into diabetes, experts say.

About 23.6 million Americans had diabetes in 2007, according to the CDC. Of that, about 5.7 million were undiagnosed diabetics. In 2008, about 8.8 percent of Pennsylvanians 18 and older had been diagnosed with diabetes, slightly higher than the national average of 8.3 percent.

In Pennsylvania, diabetes was the seventh leading cause of death in 2007, according to the state Department of Health. The disease can lead to nerve damage, kidney failure, blindness and amputation.

This fall, a CDC report predicted the number of diabetes cases in the country could triple in the next 40 years, in part because obesity is also on the rise. Annually, diabetes costs the country about $174 billion, CDC reports said.

A blood test and a hemoglobin A1C test, which provides an average of someone's blood sugar levels over a six- to 12-week period, is normally used to diagnose prediabetes, Dr. Perry said.

Once diagnosed, people with prediabetes have a good chance of staving off diabetes - or even avoiding developing it all together - by making lifestyle changes, experts say.

Topping the list is starting an exercise program, Ms. Vrablic said. New research shows that people with diabetes or prediabetes should strive for about 150 minutes of exercise a week, or about 30 minutes a day, five days a week, according to a study published in this month's issues of Diabetes Care and Medicine & Science in Sports & Exercise.

Dr. Perry said losing weight and choosing healthier foods will also help to control or even stave off diabetes.

But the problem, both Dr. Perry and Ms. Vrablic said, is convincing prediabetes and diabetes patients to make changes to their lifestyle.

"If we knew how to motivate patients, we could reduce the incidence of diabetes," Dr. Perry said, adding that doctors historically "have had remarkably little success at getting people to lose weight."

After his diagnosis, Mr. Sammon was put on medication to help control his diabetes and spends about an hour at the gym three times a week, walking on the treadmill with other people struggling with heart trouble and other medical issues. He meets regularly with a nutritionist and a nurse practitioner at Dr. Perry's diabetes clinic, which is connected to Mercy Hospital in Scranton.

"What I'm doing is keeping active, because it helps my mindset," he said. "I have lost some weight between the diet and the exercise."

Contact the writer: enissley@timesshamrock.comRisk factors

With few symptoms, millions of Americans are not aware they have prediabetes or diabetes, doctors say.

Most people are diagnosed after a test that measures fasting blood-sugar levels, taken after a patient has not eaten anything for at least eight hours. But the problem, some experts say, is that many people do not get regular screenings. Left undiagnosed, diabetes can lead to complications, including blindness, kidney failure, amputation and nerve damage.

Anthony Perry, M.D., said there are certain types of people who are more at risk to develop prediabetes or diabetes. Certain ethnic groups have a higher risk of developing diabetes. Other risk factors include:

- A family history of diabetes, especially if a parent or a sibling has been diagnosed.

- Being overweight, defined as having a body-mass index greater than 25.

- Low HDL cholesterol or high triglycerides.

- High blood pressure

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