Prediabetes
A Precursor to Diabetes
Many people
know that diabetes is a dangerous systemic illness that can lead to
serious complications such as heart disease, blindness, kidney failure,
and amputations.
What many do
not realize is that the seeds of those complications take root
long before someone succumbs to full-blown diabetes.
During that
period, called prediabetes, individuals at risk exhibit elevated blood-sugar
levels but are still capable of processing that sugar, called glucose
- the energy that powers the body's cells.
Some 41 million
Americans are estimated to have prediabetes, according to recently revised
government guidelines.
And because
November is American Diabetes Month, physicians are
taking the opportunity to warn people that even if they do not have
diabetes, their bodies still may be suffering damage from elevated blood
sugar.
"If we can identify
people before they get to the point of having diabetes, we can intervene,"
said Cathy Tibbetts, president of health care and education for the
American Diabetes Association.
"In about 58
percent of the cases, with healthier eating and increased physical activity
and a moderate loss of weight, people can successfully avoid diabetes
or delay its onset."
Diabetes at
Epidemic Numbers
About 18 million
Americans have diabetes, with 1.3 million new cases diagnosed annually.
It is the sixth leading cause of death in the US, with an estimated
200,000 deaths every year, according to federal statistics.
While an estimated
13 million people have been diagnosed with diabetes, 5.2 million people
are unaware they have the disease, the American Diabetes Association
reports.
Diabetes is
a disease in which the body does not produce or properly use insulin,
a hormone that is needed to convert sugar, starches, and other
food into energy for cells.
Most people
have type 2 diabetes, which develops as the body gradually loses its
ability to metabolize blood sugar.
The US government
adopted new guidelines this year for determining whether a person is
at risk for diabetes. Under those guidelines, two of every five adults
ages 40 to 70 is now considered to have prediabetes.
Under previous
guidelines, a person was considered to have prediabetes if his
or her sugar level after an all-night fast was 110 milligrams per
deciliter of blood. Now, prediabetes is diagnosed for sugar levels between
100 and 125 mg/dl.
The change makes
sense given that those elevated levels are doing harm to the body even
though the person is not suffering from diabetes, says Dr. Robert
Rizza, a professor of medicine at the Mayo Clinic's Division of Endocrinology,
Metabolism, Diabetes, and Nutrition.
"If you look
at people whose blood sugars are at that level, you can already find
evidence of the damage caused by diabetes," Dr. Rizza says.
For example,
people with prediabetes have a 50 percent greater risk of heart attack
and stroke, Tibbetts says. Once they actually have diabetes, their risk
of heart disease increases to two to four times that of someone without
diabetes.
People whose
post-fast blood sugar falls between 100 and 110 have a 20 percent higher
chance of developing diabetes than those whose blood sugar is healthier.
Those with blood
sugar between 110 and 125 are at 40 percent greater risk. Levels of
126 or above are considered diabetes.
What
Are the Steps to Prevent Prediabetes?
The American
Diabetes Association believes the rampant spread of diabetes
and its precursors is caused by factors that can be managed by
the individual.
"We've gotten
into some bad habits as a society," Tibbetts says. "We're less physically
active and eating larger and larger amounts of food."
Since 1990,
obesity has increased by more than 60 percent in the US. And type 2
diabetes, which is closely linked to obesity, has soared by nearly 50
percent, according to the diabetes association.
People with
prediabetes can avoid or delay the onset of full-blown disease by eating
sensibly and becoming more active, Dr. Rizza notes.
"The most important
thing is to stay lean and become fit," he says. "If you're overweight,
lose weight. And if you're sedentary then increase your activity."
Losing just
5 percent of body weight - 10 pounds for a 200-pound adult - can bring
a person's blood sugar down below prediabetes levels.
The diabetes
association recommends that people exercise portion control. Simply
eating less can go a long way toward arresting obesity.
Other association
diet tips include:
-
Eat a
total of five servings of fruits and vegetables every day.
-
Aim for
at least six daily servings of unrefined starches such as bread,
cereals, and starchy vegetables.
-
Eat sugar,
sweets, and desserts in moderation.
These foods
tend to be high in calories and fat and contain few vitamins and minerals.
Physical activity
also is an important part of weight management, and thus an important
way to avoid diabetes. Exercise can boost your metabolism, increase
muscle mass so you burn more calories, and help improve the body's response
to insulin and naturally help to lower glucose by burning extra calories.
Always consult
your physician for more information.
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November 2004
Prediabetes
A Precursor to Diabetes
Diabetes
at Epidemic Numbers
What
Are the Steps to Prevent Prediabetes?
Obesity
Prevention
Online
Resources
Other
Resources:
Find
a St. John's Mercy Physician
Diabetes
Services at St. John's Mercy
Diabetes
Health Information
St.
John's Mercy Classes and Programs
Obesity
Prevention
Many of the strategies
that produce successful weight loss and maintenance help prevent obesity.
Improving eating habits and increasing physical activity play a vital
role in preventing obesity.
Recommendations
for adults include:
-
Eat five to
six servings of fruits and vegetables daily. A vegetable serving
is one cup of raw vegetables or one-half cup of cooked vegetables
or vegetable juice. A fruit serving is one piece of small to medium
fresh fruit, one-half cup of canned or fresh fruit or fruit juice,
or one-fourth cup of dried fruit.
-
Choose whole
grain foods such as brown rice and whole wheat bread. Avoid highly
processed foods made with refined white sugar, flour, and saturated
fat.
-
Weigh and
measure food in order to be able to gain an understanding of portion
sizes. For example, a 3-ounce serving of meat is the size of a deck
of cards. Avoid supersized menu items.
-
Balance the
food “checkbook.” Taking in more calories than are expended
for energy will result in weight gain. Regularly monitor weight.
-
Avoid foods
that are high in “energy density,” or that have a lot
of calories in a small amount of food. For example, a large cheeseburger
with a large order of fries may have almost 1,000 calories and 30
or more grams of fat. By ordering a grilled chicken sandwich or
a plain hamburger and a small salad with low-fat dressing, you can
avoid hundreds of calories and eliminate much of the fat intake.
For dessert, have fruit or a piece of angel food cake rather than
the “death by chocolate” special or three pieces of
home-made pie.
-
Remember that
much may be achieved with proper choices in serving sizes.
-
Accumulate
at least 30 minutes or more of moderate-intensity activity on most,
or preferably all, days of the week. Examples of moderate intensity
exercise are walking a 15-minute mile, or weeding and hoeing a garden.
-
Look for opportunities
during the day to perform even ten or 15 minutes of some type of
activity, such as walking around the block or up and down a few
flights of stairs.
Always consult your
physician for more information.
Online
Resources
American
Diabetes Association
Centers
for Disease Control and Prevention (CDC)
Everyday
Choices, ADA, AHA, and ACS
HealthierUS.Gov
National
Diabetes Education Program
National
Diabetes Information Clearinghouse
National
Institute of Diabetes & Digestive & Kidney Diseases
National
Institutes of Health (NIH)
National
Library of Medicine
Prevengamos
la diabetes tipo 2. Paso a Paso
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