Pre-diabetes, diabetes rates fuel national health crisis

Americans are getting fatter, and older. These converging trends are putting the USA on the path to an alarming health crisis: Nearly half of adults have either pre-diabetes or diabetes, raising their risk of heart attacks, blindness, amputations and cancer.

Federal health statistics show that 12.3% of Americans 20 and older have diabetes, either diagnosed or undiagnosed. Another 37% have pre-diabetes, a condition marked by higher-than-normal blood sugar. That's up from 27% a decade ago. An analysis of 16 studies involving almost 900,000 people worldwide, published in the current issue of the journal Diabetologia, shows pre-diabetes not only sets the stage for diabetes but also increases the risk of cancer by 15%.

"It's bad everywhere," says Philip Kern, director of the Barnstable Brown Diabetes and Obesity Center at the University of Kentucky. "You almost have the perfect storm of an aging population and a population growing more obese, plus fewer reasons to move and be active, and fast food becoming more prevalent."


Tabitha Jordan of Louisville says she was eating poorly, struggling to find time for exercise and packing on pounds when her doctor diagnosed pre-diabetes in October. She recognized the danger; she'd seen her mother go blind, lose toes and eventually die from diabetes complications at age 63.

"It was kind of like, 'It's time for me to do something,' " says Jordan, 47. "I knew things had to change."

Doctors and experts coined the name pre-diabetes in the late 1990s, replacing less worrisome terms such as "borderline diabetes" that didn't convey the seriousness of the condition. Without lifestyle changes, the U.S. Centers for Disease Control and Prevention says up to 30% of people with pre-diabetes develop Type 2 diabetes within five years.

Pre-diabetes often has no symptoms; it's found through blood tests. But most of the time it remains undiagnosed. The CDC says about 10% of the 86 million afflicted adults know they have it.

"It's very clear that weight loss is far more powerful than any drug we can give," Kern says.

Jordan took a diabetes prevention class at the YMCA of Greater Louisville and now eats better and works out six days a week. A recent blood test revealed she is no longer pre-diabetic.

Doctors acknowledge others can take similar steps, but worry many won't, since it's so hard to change ingrained lifestyles.

"What we are heading toward is much higher health care costs and much more disability," said Sathya Krishnasamy, an endocrinologist with University of Louisville Physicians. "We need to make major, drastic changes as a community and as a nation."




Reprint from USATODAY September 15, 2014