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The United Nations has declared November 14, 2007 World Diabetes Day
Pre-diabetes: Are you at risk?

The United Nations has declared November 14, 2007 World Diabetes Day. Yeah, that's great, but I don't have diabetes so I don't need to pay attention to all the talk about it, I hear you say. Well maybe, maybe not.

Joslin Diabetes Center estimates that 54 million Americans have pre-diabetes. Left untreated, pre-diabetes can develop into Type 2 diabetes, which can have serious health consequences. Most people with pre-diabetes aren't even aware they have it. Are you one of them?

What is pre-diabetes?
Do you have pre-diabetes?
Why should you be concerned about pre-diabetes?
Testing and diagnosis
Should you take the test?

What is pre-diabetes?
Pre-diabetes means your blood glucose levels are higher than normal, but not high enough for you to be classified as diabetic. A diagnosis of pre-diabetes is a warning sign that should be heeded, as it means you are likely to develop Type 2 diabetes in the future, unless you take preventative action now.

The condition occurs when your insulin (the hormone that helps convert sugars from food into energy) is not working properly and can't move the glucose from the blood into the cells where it needs to be. This is known as insulin resistance.

Do you have pre-diabetes?
Early intervention can turn back the clock and return blood-glucose levels to normal. How do you know if you have pre-diabetes? You can take a blood test, but the first thing to do is to check for risk factors. Take a look at the list below and see how many risk factors are true for you:

Do you have a family history of diabetes?
Are you overweight?
Is your waist larger than 35 inches (for a woman) or 40 inches (for a man)?
Do you have a low level of physical activity?
Are you over 65 years old?
Do you have a high triglyceride level?
Do you have a low HDL cholesterol level and/or a high total cholesterol level?
Do you have high blood pressure (greater than 130 over 85)?
Do you have a history of vascular disease?
Do you have Polycystic Ovary Syndrome?
Have you had gestational diabetes (diabetes in pregnancy) or given birth to a baby weighing more than 9lbs?
What is your ethnic background?

If you answered "yes" to two or more of these questions, you are at risk for pre-diabetes.

Why should you be concerned about pre-diabetes?
Left unmanaged, pre-diabetes can develop into Type 2 diabetes within five to ten years, and this is the biggest risk. The American Diabetes Association says that over 1.5 million people were diagnosed with diabetes in 2005. The bad news is the trend is an upwards one, with diabetes having an increasingly detrimental impact upon the length and quality of life of Americans.

The best way to put the brakes on these dramatic figures is through the early diagnosis and treatment of those at risk for pre-diabetes. Studies in diabetes prevention have shown that if people are diagnosed and treated for pre-diabetes, their chances of developing Type 2 diabetes decrease dramatically. For some people with pre-diabetes, intervention can actually turn back the clock and return elevated blood glucose levels to the normal range. That's why it's so important to get checked out if you think you are at risk.

Testing and diagnosis
The only way to diagnose pre-diabetes is through a blood glucose test.

Two different blood-glucose tests can be used: The fasting plasma glucose test (FPG), in which blood glucose is measured after fasting overnight, or the oral glucose tolerance test (OGTT), in which blood glucose is measured after fasting overnight, and again after drinking a glucose-rich drink.

The FGP will show three possible diagnoses:
Normal. A fasting glucose between 70 and 100 milligrams of glucose per deciliter of blood (mg/dl);
Pre-diabetes. A fasting blood glucose level between 100 and 125 mg/dl;
Diabetes. Fasting glucose above 126 mg/dl.

The OGTT test will show three possible diagnoses:
Normal. Glucose is at 140 mg/dl;
Pre-diabetes. Glucose is at 140-199 mg/dl;
Diabetes. Glucose levels above 200 mg/dl.

Should you take the test?
Surveys show that while many people are aware of their cholesterol and blood pressure, few know their blood glucose level. If you are older than 45 and overweight, you should have regular blood glucose checks. If you are younger than 45, but have one or more risk factors for pre-diabetes, you should also have regular testing. The American Diabetes Association recommends that those with normal blood glucose should retest blood glucose levels every three years, while those with pre-diabetes should be retested for Type 2 diabetes every one to two years after diagnosis of pre-diabetes.

The good news about pre-diabetes is that it can be treated, and through treatment, the onset of Type 2 diabetes can be delayed or even prevented.

Whether you want to prevent getting pre-diabetes or reduce your chances of it progressing to Type 2 diabetes, the advice is the same. You need to make changes to your lifestyle by doing regular physical activity and eating healthily.

Here are some tips for making important lifestyle changes:

First go out and get a copy of EnLITEned Kosher Cookingthe first book that not only tells why to do it but how

It is important to work with a total health care teamdiscus this with your primary care physician

Don't make any changes in your regimen or lifestyle without first checking with your health care team

In general strive to eat foods that are low in fat and high in fiber, such as fruits and vegetables, beans, whole-grain breads and cereals

Learn correct and appropriate portion sizes and tips for control

Space your meals evenly throughout the day

Aim for at least 30 minutes of physical activity most days of the week
Remember to talk to your doctor before starting a new type of exercise to make sure it's safe

Reducing your weight by 5-10 percent, can make a difference as even a small weight loss has been found to have a big impact between pre-diabetes and developing diabetes

Maintain slow steady weight loss

Include the whole family in lifestyle changes - look after the future health of your children. The only good way to teach is by example

By taking action to manage your blood glucose when you have pre-diabetes, you can prevent Type 2 diabetes from ever developing and thats good news!

References :
This article was compiled in consultation with jewishdiabetes.com experts with excerpts from the following sources:
Jewish Diabetes Association, Diabetes Prevention- www.jewishdiabetes.org/article.asp?sivug_r=5&sivug_m=9
Jewish Diabetes Association, Procrastinate.. Me? www.jewishdiabetes.org/article.asp?sivug_r=5&sivug_m=25
Jewish Diabetes Association, Slimming Down for Summer the EnLITEned Way www.jewishdiabetes.org/article.asp?sivug_r=5&sivug_m=37
Joslin Diabetes Center, 'What is Pre-diabetes? What Should I Do If I Have It?' www.joslin.org
American Diabetes Association, 'Total Prevalence of Diabetes and Pre-diabetes' www.diabetes.org
American Diabetes Association, 'How to Tell if You Have Pre-diabetes' www.diabetes.org
American Diabetes Association, 'How to Prevent Pre-diabetes' www.diabetes.org
American Diabetes Association, 'Frequently Asked Questions About Pre-diabetes' www.diabetes.org

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