Prediabetes: keeping progression at bay
Nearly 90 percent of people with prediabetes are unaware they have it and are in danger of developing Type 2 diabetes. A simple screening can identify those at risk.
Diabetes is a debilitating chronic disease that can lead to heart disease, kidney disease and blindness if left untreated. Lifestyle modifications and medications can stop or delay the progression of the disease and can even prevent it, said Dr. Steven Kahn, UW professor of medicine, Division of Metabolism, Endocrinology and Nutrition.
Kahn said that, with greater public awareness and screening, someone with prediabetes can be identified early enough to allow for intervention before crossing over into diabetes.
Prediabetes is characterized as having abnormally high blood sugar levels, but not high enough to be diagnosed with diabetes, which is caused by the body not making enough insulin or not using insulin efficiently. It is a very high risk condition as almost everyone who develops Type 2 diabetes starts with prediabetes.
Developing diabetes is gradual and often goes unnoticed, which is why early identification is important.
“People moving from having prediabetes to diabetes may think the symptoms are just part of aging,” said Kahn. “They think nothing of getting up more at night for a drink of water. They have no idea that this is diabetes if they haven’t been identified as being at risk.”
Kahn said anyone with risk factors, such as being 45 or older, being overweight or obese, or having a history of gestational diabetes, should speak with a doctor about being screened for prediabetes. The screening is a blood test to check glucose levels. In addition, anyone with a family history of diabetes should start screening at a young age, because children and adolescents can also develop Type 2 diabetes.
The American Diabetes Association recommends screening for diabetes in adults age 45 years or older and screening in persons with risk factors, regardless of age. Several other organizations, such as the American Academy of Family Physicians, recommend screening in persons with risk factors.
In addition, the U.S. Preventive Services Task Force is updating its screening guidelines, which now focus on identifying those with abnormal blood sugar levels, then treating with lifestyle interventions before diabetes occurs.
Once someone has been screened and identified as having prediabetes, lifestyle changes, or losing just 7 percent of bodyweight, and treatment with metformin, a generic and inexpensive medication that helps control blood sugar levels, are currently the two best approaches in preventing diabetes, said Kahn.
“We know that individuals who get back to normal, going from prediabetes to normal glucose levels just once in a period of three to four years, had a rate of developing diabetes that was 50 percent less than those who never achieved it,” said Kahn.
Kahn is a researcher with the RISE (Restoring Insulin Secretion) study, which is looking at whether aggressive glucose lowering strategies can further slow or reverse the progression to diabetes in people diagnosed with prediabetes within a year’s time.
The study is looking for participants between the age of 20 and 65, who have prediabetes or who have been diagnosed with type 2 diabetes within the last 12 months and are not already on glucose-lowering therapy. The study also screens individuals who have risk factors for prediabetes, but who do not yet know they have this condition that makes them at high risk to subsequently develop diabetes. For more information, contact the Diabetes Research Group at 206.764.2788 or visit risestudy.org.
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