Prediabetes Ignored Way Too Often

Only half of Americans with prediabetes take steps to avoid progression to diabetes, according to a recent report in the American Journal of Preventive Medicine.

Prediabetes is defined as:

  1. fasting blood sugar between 100 and 125 mg/dl (5.56–6.94 mmol/l) or
  2. blood sugar level 140–199 mg/dl (7.78–11.06 mmol/l) two hours after drinking 75 grams of glucose

Prediabetes is a strong risk factor for development of full-blown diabetes.  It’s also associated with increased risk for cardiovascular disease such as heart attack and stroke.  One of every four adults with prediabetes develops diabetes over the next 3 to 5 years.  The progression can often be prevented by lifestyle modifications such as dietary changes, moderate-intensity exercise, and modest weight loss.  

Investigators looked at 1,402 adult participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES) who had fasting blood sugar tests and oral glucose tolerance tests diagnostic of  prediabetes.  

The researchers estimate that 30% (almost one out of every three) of the adult U.S. population had prediabetes in 2005-2006, but only 7% of them (less than one in 10) were aware they had it.

Only half of the prediabetics in this survey reported attempts at preventative lifestyle changes in the prior year.  Only one of every three prediabetics reported hearing about risk reduction advice from their healthcare provider.

People, we’ve got to do better! 

My fellow physicians, we’ve got to do better!

The U.S. Centers for Disease Control and Prevention predicts that one of every three Americans born in 2000 will develop diabetes.  The great majority of this will be type 2 diabetes.  You understand now why James Hirsch, author of Cheating Destiny, calls diabetes America’s leading public health crisis.  I agree.

Steve Parker, M.D.

Reference:  Geiss, Linda S., et al.  Diabetes risk reduction behaviors among U.S. adults with prediabetesAmerican Journal of Preventive Medicine, 38 (2010): 403-409.


Filed under Causes of Diabetes, coronary heart disease, Overweight and Obesity, Prevention of T2 Diabetes, Stroke, Weight Loss

5 responses to “Prediabetes Ignored Way Too Often

  1. nmgrandma

    I was told in the mid 80’s that I was “glucose intolerant” but nothing more as to what that meant, other than that I would eventually develop diabetes. I was aware that my grandmother was diabetic but didn’t know what that meant. Later I learned that my mother and all my siblings (2 brothers and 1 sister) had diabetes. I consider myself lucky to have so far avoided that diagnosis!

    Even as recently as 2007 I was told “to watch my sugars”. Fortunately, I have been studying nutrition and diabetes for 3 decades and now know that I am more knowledgeable about diabetes (both prevention of, and treatment of) than most doctors that I have seen in those same 3 decades.

    My husband who had no family history of diabetes but is severely obese has, to his disbelief, been diagnosed with diabetes. He is trying to deny the diagnosis but is willing to follow the low carb diet that I have very successfully used for years to control my blood sugar and my weight. His lipid profile showed such an improvement that I actually questioned whether it was his blood sample that was tested. All of his numbers were well within the healthy range. Previously his cholesterol had ranged from 215 to more than 250. It was 214 on 11/23, and 143 on 3/25. However, his A1C on 3/25 was 11.4. Again, the doctor just told him to watch his “sugars” and put him on Metformin. For years his doctors have told him that he needed to lose weight but he ignored them. He is now paying the price.

    Doctors are definitely not doing their patients any favors when it comes to treating pre-diabetes. As the population ages and obesity increases, we are in for an epidemic of diabetes. Thank goodness for the wonderful resources available on the Internet for those who want additional help. I highly recommend your website, along with David Mendosa’s website, and reading all the available info that these forums recommend.

  2. Thanks for your input, nmgrandma.

    About 15 years ago, the definition of diabetes (by blood sugar levels) was changed to include millions more people overnight. I have to confess my first thought was, “They’re just trying to create more patients to sell drugs to.”

    I realize now that was wrong.

    I also have much respect for David Mendosa.


    • Same for pre-hypertension. Treating the pre-hypertensive phase decreases the number of people progressing to hypertension. These diseases are a self-feeding cycle.

  3. N12

    I was told for years that my blood sugar was fine, even though I told them I had problems. I gave up on doctors and just tried to watch my diet. I recently broke down and bought a glucose meter and started testing. I am definitely pre-diabetic and perhaps diabetic. I was shocked to see my BG level after certain foods, like fruit. Of course, I would stay elevated and be borderline diabetic 12 hours later. I gave up all fruit and veggies for now. I am still eating some oats for now, until I can figure out the best system. Oats might work in moderation for me. Hummus raises my BG almost as high as oats with sugar. Maybe it’s the lemon juice in the store-bought hummus, I’m not sure. I think the U.S. medical system has failed me.

    • Hi, N12. How’s R2D2?

      Having made hummus myself, I doubt it’s the lemon juice raising your blood sugars – it’s not that much lemon juice. More likely it’s the starchy legume: garbanzo beans (aka chick peas).

      I’m afraid too many physicians don’t take prediabetes seriously enough.

      How about non-starchy vegetables like lettuce, spinach, broccoli, cauliflower, onions, tomatoes, and cucumbers. Many people with altered carbohydrate metabolism can tolerate them, although onions and tomatoes may need some limitation.