By Susan Okie

The government yesterday for the first time urged overweight Americans to get tested for a newly defined condition called "pre-diabetes" as part of a campaign to stem a growing epidemic of diabetes in the United States.

The recommendation was prompted by the recent recognition that people who are at risk of developing diabetes can be identified and their risk of going on to develop the full-blown disease can be cut substantially by weight loss and exercise.

"Diabetes has reached epidemic proportions and it's still on the rise," Health and Human Services Secretary Tommy G. Thompson said at a briefing March 28. "What gives us hope is that people with pre-diabetes can take meaningful steps now to reduce their risks and avoid having diabetes."

The rising incidence of diabetes in the United States is the result of a dramatic increase in obesity, as well as the aging of the population. The latest figures show that in addition to the estimated 17 million Americans who have full-blown diabetes, at least an additional 16 million have "pre-diabetes," Thompson said.

People with pre-diabetes have levels of glucose (a sugar in the bloodstream) that are higher than normal but not high enough to be classified as diabetes. It causes no symptoms, but without treatment most people with the condition go on to develop diabetes, which is the sixth leading cause of death in the United States and a major contributing cause of heart disease, stroke, kidney failure, high blood pressure and blindness.

Thompson said HHS will also try to persuade health insurers and employers to pay for testing and treatment to prevent diabetes, a disease that is estimated to cost the U.S. economy $100 billion annually. Except for certain screening tests mandated by Congress, the federal Medicare program does not pay for preventive treatment.

According to the new recommendations, pre-diabetes can be diagnosed by a fasting plasma glucose (FPG) test measures the level of glucose in the bloodstream after an overnight fast.

The guidelines state that testing is strongly recommended for anyone who is 44 or older and overweight (defined as a Body Mass Index of 25 or higher). They say doctors should also consider testing people older than 44 who have no risk factors, as well as younger adults who are overweight and who have at least one other risk factor for diabetes.

If the test for pre-diabetes is normal, it should be repeated every three years, according to the recommendations. If pre-diabetes is diagnosed, the patient should receive counseling on weight loss and increasing exercise and should be monitored every year or two for possible diabetes.

Washington Post March 28, 2002; Page A08

Dr. Mercola's Comments:

Normal fasting blood glucose is below 100 mg/dl. A person with pre-diabetes has a fasting blood glucose level between 110 and 125. If the level rises to 126 or above, a person has full-blown diabetes. My question is, why would anyone wait for their blood sugar to get to 100 before they were concerned? I have checked over 10,000 blood tests on my patients and can tell you quite confidently that your fasting blood sugar should be below 100. Previously, I believed the fasting blood sugar should be 87. It now seems that the numbers should be closer to 80. My definition of pre-diabetes is when that number rises above 100. Pre-diabetes is far easier to turn around in the earlier stages than the later stages. It is important to recognize that the new recommendations are for everyone over 44 years of age to have a fasting blood sugar as a screen. If you are overweight you should also have it every year. Amazingly, 25 percent of obese children under 10 had either blatant or pre-adult onset type 2 diabetes. One-quarter of the obese children under 10 in the United States may have diabetes, so, it is never too early to screen for diabetes in obese individuals. The top medical journal, the New England Journal of Medicine (NEJM), in May 2001 proclaimed that dietary modifications were able to reduce the rate of diabetes by nearly 60 percent, and they did this without even understanding some of the most basic foundational truths of food choices. These investigators were absolutely clueless with respect to the influence of grain and sugar restriction on insulin optimization. So, if the traditionally recommended low-fat diet can reduce diabetes by 60 percent, if you use the food choices I recommend you can reduce type 2 diabetes by well over 95 percent. Exercise is unquestionably also a big key here. Considering that there are 15 million diabetics in the United States and the epidemic is continuing to increase in this country and worldwide (affected about 6 percent of persons in developed countries in 1995), this is important information. Folks, believe me, you do not want to play around with diabetes. It is a devastating illness and will gradually suck the life out of you and contribute to a life full of miserable health complications. It is also one of the fastest ways to accelerate the aging process. Related Articles: Diet and Exercise Reduces Risk of Diabetes Exercise Reduces Diabetes by Reducing Insulin Exercise Helps Diabetics Want to Stop Diabetes? Start Exercising