It's no secret; diabetes in America is growing at epidemic speed. Approximately
90% of all cases are of the "type 2" variety, once called "adult
onset diabetes." Type 2 is gradual, ambiguous, and by the time it is diagnosed,
can have caused serious damage to eyes, kidneys, and heart. Diabetes can be
treated -- if you and your doctor know you have it. Complications can be prevented,
delayed, or mitigated -- if they're caught in time.
Many people have a diabetes-like condition known as "Impaired Glucose Tolerance," or IGT, once called "Borderline Diabetes." Authorities are now using the term "Pre-Diabetes," reflecting that in this population, you will find tomorrow's newly-diagnosed type 2 diabetics -- and the sooner they're identified, the sooner they can be treated, to reduce their risk of complications.
Leading US diabetes research and advocacy groups are now recommending screening
for "prediabetes." Their recommendations call for physicians to give
fasting plasma glucose or oral glucose tolerance tests to overweight people
aged 45 years and older, and the same tests for people younger than 45 if they
are seriously overweight (a body-mass index greater than 25 kg/m2) with other
risk factors, particularly hypertension or a family history of diabetes. Overweight
nonwhites are considered at high risk.
Individuals with prediabetic glucose levels need counseling about lifestyle
changes that can delay or prevent diabetes (diet, exercise, weight loss). Most
of them will probably not need medication, at least for some time. Regular follow-up
counseling, encouraging dietary improvement, weight loss and regular exercise
appears important in these cases.
For more information, see Diabetes Care. 2002;25, and JAMA (Journal of the
American Medical Association): Vol 287, No. 19.