HEALTH MATTERS: Preventing the progression from pre-diabetes to diabetes is critical
Q. I've just been diagnosed with pre-diabetes. What is it, how should it be treated and should I be worried? A. Pre-diabetes is a condition in which the sugar or glucose levels in the body are higher than normal, but not high enough to qualify as...
Q. I've just been diagnosed with pre-diabetes. What is it, how should it be treated and should I be worried?
A. Pre-diabetes is a condition in which the sugar or glucose levels in the body are higher than normal, but not high enough to qualify as diabetes. Millions of Americans have pre-diabetes and are at risk of progressing to full-blown diabetes.
It is a common condition affecting some 80 million Americans. Often related to obesity, the best way to treat it, and thus reduce the risk of getting diabetes, is to exercise and lose weight.
We usually recommend between 5 and 10 percent weight loss, so for a 260 pound man, we're talking about 13 to 26 pounds. In occasional cases, medication also is used, but for most people, weight reduction and sensible exercise are the keys.
Because diabetes can lead to a host of complications -- including heart disease and stroke, kidney failure, blindness and other vascular complications -- trying to prevent the progression from pre-diabetes to diabetes is worth the effort. So, while unfortunately you are one of many who have pre-diabetes, you needn't be overly concerned -- but get out there, exercise, and lose weight. You'll be glad you did.
Q. Our son has Type I diabetes and my grandfather has Type II diabetes. I thought that diabetes was diabetes. What's the difference?
A. Diabetes is a condition in with the sugar level in the blood is too high. The sugar level normally is controlled by a compound called insulin, which is produced by the pancreas.
When glucose levels are too high, the glucose spills from the blood into the urine and drags fluid with it. This is why some people with diabetes are thirsty and urinate excessively. But diabetes also damages various blood vessels in the body, and many of its complications are related to this.
Type I diabetes, usually found in young people like your son, is due to inadequate production of insulin by the body. The treatment is to give insulin by injection so that the body gets adequate insulin to control the level of sugar.
Type II diabetes typically is a disease of middle age or older individuals, but recently, we are seeing it being diagnosed at younger ages because of the obesity epidemic.
Type II diabetes often is due to partial resistance to the effects of insulin. That means insulin levels may actually be high even though the sugar levels are too high. Eventually, the pancreas wears out, and the insulin levels may fall.
Treatment typically is with pills at least initially, which help to regulate the sugar levels. However, eventually a good number of people with Type II diabetes end up on insulin, often when insulin levels fall as the pancreas wears out. Both types of diabetes can lead to vascular complications and proper treatment can reduce or prevent some but not all of the complications.
While both types can run in families and be inherited, great variation occurs in the patterns of inheritance. For example, one of identical twins might have diabetes while the other does not. Weight reduction is an important component of treatment for either type of diabetes if the patient is overweight.
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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