Tag Archives: impaired glucose tolerance

Yet Another Study Links Impaired Sugar Metabolism With Dementia

…according to an article at MedPageToday. A cohort of patients with mild to moderate Alzheimer’s were found to have unexpectedly high rates of impaired glucose tolerance or outright type 2 diabetes. We don’t know for sure if impaired glucose metabolism is a cause of dementia, or if some other factor links the two conditions. Until we have that answer, if I had impaired glucose metabolism, I’d work to improve it with loss of excess weight, exercise, and low-carb eating.

Here’s another article I wrote wondering if diabetes causes dementia.

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Does Weight Loss Prevent Type 2 Diabetes?

Finger-pricking four times a day gets old real quick!

Finger-pricking four times a day gets old real quick!

I found an interesting statistic in a scientific journal article last year:

Every 2.2 pound (1 kg) loss of excess weight lowers the risk of developing type 2 diabetes by 16%.

That tidbit was embedded in another article with a focus on regain of lost weight over time.  The “16% per kilogram” number sounded too good to be true, and I had never heard it before.  So I did some digging and found the source of the statistic.  Ain’t the Internet wunnerful?

The origin of the 16% figure is the Diabetes Prevention Program Research Group.  Investigators enrolled 1,079 middle-aged (mean 50.6 years) study participants and followed them over 3 years, noting the effects of exercise, percentage of fat in the diet, and weight loss on the subsequent development of diabetes.  Average body mass index was 33.9.  (A 5-foor, 4-inch person weighing 197 pounds (89.5 kg) has a BMI of 33.9).  Sixty-eight percent of participants were women.  The investigators’ goal for this group of overweight people was for loss of 7% of body weight through diet, physical activity, and periodic counseling sessions.  Average weight loss over the course of three years was 9 pounds (4.1 kg).

None of the study participants had diabetes at the time of enrollment.  But, by design, they all had laboratory-proven “impaired glucose tolerance.”  Impaired glucose tolerance is a form of “pre-diabetes.”  It is determined by giving a  75-gram dose of glucose by mouth, then measuring blood glucose (sugar) 2 hours later.  A blood glucose level under 140 is normal.  If the level is 140-199, you have impaired glucose tolerance.

Having impaired glucose tolerance means that study participants’ glucose (sugar) metabolism was already abnormal.  They were at higher than average risk of developing diabetes, compared with both average-weight healthy people and overweight people without impaired glucose tolerance.  This is a great cohort to study for development of diabetes.  But the finding that “every 2.2 pounds of weight loss lowers the risk of diabetes by 16%” applies to this particular group with impaired glucose tolerance, not the general overweight population.

A total of 153 participants developed diabetes over the course of 3 years.  Loss of excess weight was by far the best predictor of lowered diabetes risk, compared with regular exercise and lowering percentage of dietary fat.

Yes, weight loss does prevent diabetes in some, probably many, overweight people.  The specific degree of reduced risk depends on numerous factors, such as age, sex, genetics, degree of weight loss, and pre-existing impaired glucose tolerance.

Steve Parker, M.D.

Reference: Hamman, Richard, et al.  Effect of Weight Loss With Lifestyle Intervention on Risk of Diabetes.  Diabetes Care, 29, (2006): 2,102-2,107.

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Diabetes Increases Dramatically

On June 24, 2008, the Centers for Disease Control released prevalence data for diabetes in the U.S.  Nearly 24 million people now have diabetes, up three percent over just two years.  This is eight percent of the population.  The vast majority of cases are of type 2 diabetes, not the type 1 usually diagnosed in childhood.

Another 57 million people have pre-diabetes, a condition that can turn into full-blown diabetes over time.  The two types of pre-diabetes are “impaired fasting glucose” and “impaired glucose tolerance.”

The CDC broke down diabetes prevalence for various age groups.  Twenty-three percent of people over 60 have diabetes.  Eleven percent of all adults have diabetes.

The 24 million figure includes six million who have diabetes but have not yet been diagnosed.

I expect to see even more diabetes cases in the future as our overweight population ages.

Risk factors for the development of type 2 diabetes include aging and genetic heritage.  You can’t do anything about those.  But two other major risk factors are under your control: habitual inactivity and excessive body fat.

If you don’t want to be one of these statistics, now you know what you need to do.

Steve Parker, M.D.

Additional information:

WebMD Diabetes Guide

American Diabetes Association

The Prevention or Delay of Type 2 Diabetes

Does Weight Loss Prevent Type 2 Diabetes?

Mediterranean Diet Reduces Risk of Type 2 Diabetes

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