About 1 in 3 American adults have so-called pre-diabetes

[MichaelB]

About 1 in 3 American adults have so-called pre-diabetes, a 39 percent jump over 2008 estimates, the U.S. reported. The condition signals higher-than-normal blood sugar, and can lead to diabetes, heart attack and stroke.
Pre-diabetes now affects about 79 million people in the U.S., the Centers for Disease Control and Prevention said in a report. Almost 26 million Americans have diabetes, though about 7 million are undiagnosed, the Atlanta-based agency said.
More Than 1 in 3 Americans Found to Have Pre-Diabetes - Bloomberg

We wonder why our health care is so expensive.

 

[Coach]

That's a striking increase -- I wonder if Americans have changed, or if the definition of "pre-diabetes" has.

Coach

 

[RonBoyd]

I guess, this fits in here:

YouTube - CNN: Diabetes type-2 can be reversed

 

[harley]

That's a striking increase -- I wonder if Americans have changed, or if the definition of "pre-diabetes" has.

Coach

Both. I'm sure the numbers of Americans with higher blood sugar is increasing, but just in my awareness of diabetes lifetime they have lowered the acceptable numbers from 126 (Fasting) to 100. Same with cholesterol and blood pressure. Hmmm, according to another study* pharmaceutical company profits have risen right along with the number of people who are swept up in the new disease definitions.

* study I made up, but I'm sure is accurate.

 

[RonBoyd]

* study I made up, but I'm sure is accurate.

I am going to, immediately, add you to my List of Sources.

 

[Westernskies]

Both. I'm sure the numbers of Americans with higher blood sugar is increasing, but just in my awareness of diabetes lifetime they have lowered the acceptable numbers from 126 (Fasting) to 100. Same with cholesterol and blood pressure. Hmmm, according to another study* pharmaceutical company profits have risen right along with the number of people who are swept up in the new disease definitions.

* study I made up, but I'm sure is accurate.

Harley,
Thank you for posting your professionally documented "study". Good to see someone posting well-researched data here on e-r.org instead of irresponsible, knee-jerk emotional rhetoric ... May I quote you as "a reliable source" in the future whenever I need to back up a point?
WS

 

[braumeister]

Only the tip of the iceberg, my friends.

The dirty little secret the medical community is keeping from you is that more than nine out of ten North Americans currently suffer from senescence.

Look it up if you doubt:

wikipedia: Senescence

Senescence of the organism gives rise to the Gompertz–Makeham law of mortality, which says that mortality rate rises rapidly with age.

Don't just sit there; call your Congresscritter right now and demand that something be done about this scourge.

 

[CoolChange]

Only the tip of the iceberg, my friends.

The dirty little secret the medical community is keeping from you is that more than nine out of ten North Americans currently suffer from senescence.

Look it up if you doubt:

wikipedia: Senescence



Don't just sit there; call your Congresscritter right now and demand that something be done about this scourge.

Actually, I really wish the government would fund general anti-aging research the same as research into specific diseases rather than abdicating to groups like https://www.mfoundation.org and SENS Foundation | Advancing Rejuvenation Biotechnologies.

 

[Bestwifeever]

Only the tip of the iceberg, my friends.

The dirty little secret the medical community is keeping from you is that more than nine out of ten North Americans currently suffer from senescence.

Look it up if you doubt:

wikipedia: Senescence



Don't just sit there; call your Congresscritter right now and demand that something be done about this scourge.

Even worse is the number of people with pre-senesence. A global problem!

 

[MichaelB]

OMG. I shoulda' known better than to post that story. Now I have a new disease. Betcha if I tell DW she'll find a supplement at Whole Foods that treats it.

 

[FIRE'd@51]

I guess, this fits in here:

YouTube - CNN: Diabetes type-2 can be reversed

The headline caption of the video is misleading - Type II diabetes can be controlled by diet, exercise, and medication, but not reversed in the sense that it is cured. Even the doctor in the video says if he were to resort to his old dietary habits, the high blood sugar levels would return.

What may be possible, is that pre-diabetes may be kept from developing into full-blown diabetes by lifestyle changes.

 

[Rich_by_the_Bay]

I'm guessing the next set of guidelines will lean more heavily on glycohemoglobin (hgbA1C) than it now does, partly because of present technical inconsistencies in the test. It seems to be a better predictor of outcomes than glucose-based parameters in some studies.

 

[FIRE'd@51]

I'm guessing the next set of guidelines will lean more heavily on glycohemoglobin (hgbA1C) than it now does, partly because of present technical inconsistencies in the test. It seems to be a better predictor of outcomes than glucose-based parameters in some studies.

A question I have about the A1c is that, since it's effectively an average blood sugar, how does one know whether or not it is being artificially lowered by hypo's.

 

[Martha]

A question I have about the A1c is that, since it's effectively an average blood sugar, how does one know whether or not it is being artificially lowered by hypo's.

Rich or one of the MDs should answer, but my understanding is that frequent hypoglycemia could result in an artificially low A1c reading.

 

[Rich_by_the_Bay]

New red blood cells start life with little or no glucose attached to their hemoglobin. As they get exposed to glucose in the blood, it irreversibly gets attached to hemoglobin to an extent dependent on blood glucose levels.

New and old red cells mix over time such that the glycohemoglobin (glucose bound to hemoglobin in the red cell) equilibrates to a level representing the average exposure over the past 2-3 months.

It is roughly an arithmetic average so that very high glucose combined with very low glucose could result in a normal hgbA1C reading. Practically, it is not often a problem since HgbA1C is not interpreted like a blood sugar, but rather as a long term barometer of control.

Hope that helps.

 

[Westernskies]

New red blood cells start life with little or no glucose attached to their hemoglobin. As they get exposed to glucose in the blood, it irreversibly gets attached to hemoglobin to an extent dependent on blood glucose levels.

New and old red cells mix over time such that the glycohemoglobin (glucose bound to hemoglobin in the red cell) equilibrates to a level representing the average exposure over the past 2-3 months.

It is roughly an arithmetic average so that very high glucose combined with very low glucose could result in a normal hgbA1C reading. Practically, it is not often a problem since HgbA1C is not interpreted like a blood sugar, but rather as a long term barometer of control.

Hope that helps.

Thanks, Rich from 1 of those 3 Americans...

 

[TargaDave]

What may be possible, is that pre-diabetes may be kept from developing into full-blown diabetes by lifestyle changes.

So safe to assume that pre-diabetes stats correlate well with obesity stats and that the numbers are getting worse each year? Isn't the US supposed to have some of the worst diabetes numbers of developed countries? So simple to remedy and yet it seems like a lost battle.

 

[chinaco]

This is probably one of the biggest problems with our health care system.


If it is determined to lifestyle related and could be dealt with through diet and exercise related... the insured should be rated and pay a substantially higher premium.

 

[kramer]

Hmmm, I see some confusion here, at least regarding health care economics. Recall that obese people, smokers, and especially obese smokers use less lifetime health care than healthy people.

Kramer

In the Balance

Similar to the finding that prevention rarely saves money is the calculation that people in good health probably rack up higher lifetime medical costs than their less-healthy brethren.
The reason? Healthy people tend to live longer.
The Framingham Heart Study has followed more than 5,000 people in a town outside Boston since 1948. An analysis published in 2003 found that obese women smokers lost 13.3 years of life, and obese men smokers lost 13.7 years, compared with normal-weight nonsmokers. This loss of longevity can make a big economic difference because people who miss old age miss the high medical costs associated with it.
In the journal PLoS Medicine last month, Dutch researchers led by Pieter H.M. van Baal used mathematical modeling to compare the medical expenses (starting at age 20) of healthy people, obese people and non-obese smokers.
Up to age 56, an obese person's annual medical costs are higher than a smoker's, mostly because of problems that often come along with obesity, such as diabetes, arthritis and lower back pain. Healthy people have the lowest annual cost.
But over a lifetime, the researchers calculated, healthy people incur the most cost, followed by the obese and then smokers, who die the earliest.
Does that mean we shouldn't try to get people to quit smoking or lose weight?
Of course not, says Louise Russell, the "Is Prevention Better Than Cure?" author who is now a research professor at Rutgers University in New Jersey.
"People are important, their health is important, and we want to make their lives better in a variety of ways," Russell said. "The point of the medical-care system is to serve people. It is not the point of people to serve the medical-care system."
Prevention can be a great investment, but it's still an investment. Nothing in the modern health-care economy is cheap.

 

[kramer]

Type 2 diabetes runs in my family big-time. My dad and one of my grandfathers had it. One of my 3 uncles had it and supposedly my great grandfather and all 3 of his brothers had it.

I was tested 1.5 years ago and my fasting number had creeped up to 98 from 87. Enough to cause me concern due to my family history and age at the time (43). Anyway, I learned all about glycemic indexes in food and did not radically change my diet but stopped the excesses, mostly in refined carbohydrates. I also worked with a friend on a medical school faculty because I was having trouble finding confirmation that exercise was really a risk factor independent of weight (because I am already have health BMI and because all those sites on the internet were not specific about this). He assured me that recent research proved it so, that additional exercise benefits even those with healthy BMI in regards to pre-diabetes, although doctors were not absolutely sure of this until recently (he mentioned he had a recent paper on that topic on his desk when he replied to my email)

I was already running a hard 5 kilometers every other day and I added lifting weights on the other days. This study supports the combination of aerobics and resistance training as opposed to solely focusing on one or the other (my case is not exactly this because in addition to adding resistance training I was exercising more overall):

Exercise Combination Cuts Blood Sugar in Type 2 Diabetics - WSJ.com

Anyway, my last checkup showed my fasting blood sugar this September back down to 87, when I breathed a sigh of relief.

Also, exercise probably helps in ways that scientists do not fully understand, boosting the immune system and assisting with anti-aging at the cellular level:

The Hidden Benefits of Exercise - WSJ.com

 

[Badger]

Hmmm, I see some confusion here, at least regarding health care economics. Recall that obese people, smokers, and especially obese smokers use less lifetime health care than healthy people.

Kramer

In the Balance

Then factor into the equation that they won't put a strain on SS payout.

Cheers!

 

[FIRE'd@51]

Practically, it is not often a problem since HgbA1C is not interpreted like a blood sugar, but rather as a long term barometer of control.

Not sure exactly what you mean by this. Lower A1c seems to be correlated with fewer diabetes-related complications. But isn't this just another way of saying that, for diabetics, the lower the average blood glucose the better? As I understand it, the only way to estimate the average blood glucose (EAG) practically and economically is to measure A1c. There is even a formula that relates EAG to A1c. The ADA is recommending using this formula to do the conversion and reporting the EAG to patients instead of the A1c

Estimating Average Blood Glucose

 

[Rich_by_the_Bay]

Not sure exactly what you mean by this.

Marked glucose volatility may be overlooked if you rely solely on the HgbA1C. That is one reason why you look at home blood glucose readings, symptoms, and other factors as well. And occasionally patients may not be forthcoming about poor control at home, then behave themselves a few days before their doctor visits. The glycohemoglobin may be a useful tipoff and lead to beneficial discussions.

I imagine that average blood sugar, taken at strictly controlled times and firmly structured insulin or medication use would be useful, but much more cumbersome. Plus the outcome studies are much more robust with hgbA1C. But yes, EAG and HgbA1c could reasonably be considered as proxies for one another under the right circumstances.

 

[FIRE'd@51]

Marked glucose volatility may be overlooked if you rely solely on the HgbA1C. That is one reason why you look at home blood glucose readings, symptoms, and other factors as well. And occasionally patients may not be forthcoming about poor control at home, then behave themselves a few days before their doctor visits. The glycohemoglobin may be a useful tipoff and lead to beneficial discussions.

I imagine that average blood sugar, taken at strictly controlled times and firmly structured insulin or medication use would be useful, but much more cumbersome. Plus the outcome studies are much more robust with hgbA1C. But yes, EAG and HgbA1c could reasonably be considered as proxies for one another under the right circumstances.

I think you are missing my point (or more likely, I am making it poorly).

The ADA is recommending that patients still have their A1c checked bi-annually, but that the results be converted to EAG with the formula cited in my link, with the hope that the EAG will indicate to the patients that perhaps the average number they are getting from their home meters is artificially biased low due to infrequent testing (e.g. once a day) and also testing at times which are more convenient (e.g. before meals as opposed to after).

As I understand it, in the study to come up with a formula relating A1c to EAG, the subjects wore 24-hour meters that took readings at regular intervals (e.g. every X minutes). They then regressed the average of these data aginst the A1c measurements to come up with the formula cited in my link.

Thus, the only real difference is that the same results will be reported to the patient as a different number. I would guess many doctors have (or should have) tables like the one cited in my link so, that they can tell their patients what the A1c number means in terms of average blood sugar level.

Finally, IMO, the upside of this is that maybe doctors, patients, and even the ADA itself will recognize that an A1c of 7% (EAG = 154) is really pretty lousy blood glucose control. Think about what range of blood glucose values would likely lead to an average of 154. Someone whose blood sugar averaged 154 is probably experiencing dangerous levels of blood sugar much of the time.

 

[Khan]

Interesting.
I was obese for several years (40s & 50s) and did not develop diabetes.
Mother did develop diabetes (insulin dependent) in her 50s.
I wonder if it was because I got fat on fat and meat and not on sugar.