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Long before a person develops type 2 diabetes, many people begin exhibiting elevated blood-glucose levels that are higher than normal but not yet high enough for a diabetes diagnosis. Until recently, health-care providers referred to this state as Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG), depending upon which diagnostic test was used to detect it. For years, we believed nothing could be done about this condition. So nothing was. Now, research tells us there is plenty we can do about pre-diabetes, the new name given to having blood-glucose levels in the intermediate range. In fact, one recent study found that for many people, it is even possible to reverse this condition and return blood-glucose levels to normal. The Diabetes Prevention Program, a landmark study sponsored by the National Institutes of Health, found that losing 5 to 7 percent of body weight and increasing physical activity such as walking, for at least 30 minutes five times a week, could lower a person's chances of developing diabetes by nearly 60 percent. Some people in the study, who had pre-diabetes, succeeded in lowering their blood-glucose levels all the way back to normal. Because of this, the American Diabetes Association and the U.S. Department of Health and Human Services now recommend that anyone who is overweight and over the age of 45 be tested for pre-diabetes during routine medical-office visits. Some people in this age group who are not overweight should also be tested, if they have other risk factors for diabetes (see box on page 4) and their health-care provider believes it is necessary. Because pre-diabetes, like type 2 diabetes, usually develops without any warning signs or symptoms, getting tested is the only sure way to find out if you have it. There are two simple tests for pre-diabetes, and they are the same tests used to detect diabetes. Both require fasting. The fasting plasma glucose test (FPG) measures a person's bloodglucose levels, ideally first thing in the morning, after an overnight fast. The oral glucose tolerance test (OGTT) measures blood-glucose levels twice: once after fasting, and again two hours after drinking a sugar-rich drink. Either test is appropriate and should be repeated once every three years, if normal. There is every reason to take one of these tests. Studies show that most people with pre-diabetes go on to develop type 2 diabetes within 10 years. Simply having pre-diabetes puts you at a higher risk for heart disease and stroke than people whose blood-glucose levels are in the normal range. But most importantly, learning you have pre-diabetes gives you a critical opportunity to make changes that could save your life and improve it. What You Should Know About Pre-Diabetes
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While health-care providers and researchers don't know exactly what causes diabetes, recent groundbreaking research tells us that, unlike many other chronic diseases, type 2 diabetes can be prevented, or at least delayed. That's because diabetes can be detected years before the disease has fully developed. 