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?"

First Push: Exercise and Healthy Diet
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."

Second Push: Control Heart Problems
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.

Online Resources

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American Association of Clinical Endocrinologists

American Diabetes Association

American Heart Association

Centers for Disease Control and Prevention (CDC)

Everyday Choices - ADA, AHA, and ACS

National Diabetes Information Clearinghouse

National Heart, Lung, and Blood Institute (NHLBI)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)