Holland Hospital - Healthy Life Spring/Summer 2006

Could You Have
Pre-Diabetes?

Diabetes is a growing problem in America. An estimated 20.8 million people — nearly 7 percent of the population — have type 1 or type 2 diabetes. A whopping 1.5 million new cases were diagnosed in 2005 alone. In an effort to slow the increase, doctors have recently begun to identify individuals at risk for diabetes before they develop the disease.

They call it "pre-diabetes." The diagnosis gives individuals a chance to delay or prevent the development of type 2 diabetes, a condition in which the body does not produce or properly use insulin, a hormone needed to convert food into energy necessary for daily life. Diabetes is also a leading risk factor for cardiovascular disease.

Pre-diabetes occurs when blood glucose levels rise above normal, but have not yet reached the diabetic range. The American Diabetes Association estimates that as many as 41 million Americans, or 40 percent of individuals between 40 and 74 years old, have pre-diabetes. And if they don't take steps to control their risks, studies show that most of those people will develop diabetes within 10 years.*

How to tell if you have pre-diabetes
Pre-diabetes develops silently — it has no obvious signs or symptoms. But certain risk factors may make you more susceptible. If you are 45 years old or older, talk to your doctor about getting tested — particularly if you are overweight. You may also want to consider getting tested if you are younger than age 45 and have any of the following risk factors:

Family history of diabetes
Overweight or obesity
Low HDL cholesterol and high triglycerides
High blood pressure
History of gestational diabetes or giving birth to a baby weighing more than nine pounds
African-American, Latino, Native-American or Asian-American ethnic origin

To determine whether you have pre-diabetes, doctors may conduct the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). Both tests require that you fast overnight. The FPG measures your blood glucose level before you eat anything in the morning. A level between 100 mg/dL and 126 mg/dL indicates impaired fasting glucose, or prediabetes. The OGTT takes the same measurement, then checks the level again two hours after drinking a glucose-rich drink. Results between 140 mg/dL and 200 mg/dL suggest impaired glucose tolerance, another name for pre-diabetes.

5 tips to help keep diabetes at bay
A National Institutes of Health (NIH) study of individuals with pre-diabetes found that simple lifestyle changes reduced their risk of developing type 2 diabetes by 58 percent. To control your risk, consider the following:
1. Exercise and eat right. The NIH study showed that those who exercised 30 minutes a day, five days a week, and followed a low-fat, low-calorie diet were less likely to develop diabetes than their inactive counterparts.
2. Lose weight. Reducing your weight by 5 percent to 10 percent, in combination with eating right and exercising, may help you impede or avoid diabetes altogether.
3. Control blood pressure. Experts recommend taking whatever steps are necessary to reach a blood pressure reading of 130/80 or below.
4. Quit smoking. Kicking the habit can improve your body's ability to use insulin properly, while reducing your risk for other health problems.
5. Talk to your doctor. Discuss your risk factors for pre-diabetes and whether you should be tested.

LEARNING TO LIVE WITH DIABETES

Whether you're newly diagnosed with diabetes or need a brush-up on the best ways to manage the disease, Holland Hospital's Diabetes Self-Management Education Program can help.

The program is staffed by diabetes nurse educators who provide one-on-one consultations with adults who have been newly diagnosed, followed by classes on topics ranging from choosing healthy foods and carbohydrate counting, to blood glucose testing and the importance of exercise in controlling blood sugar levels.

The goal of the program, according to Angela Kuklewski, RN, certified diabetes educator and program coordinator, is to help people "take ownership of their health."

"Diabetes is a patient-managed disease. We teach them what to watch for,
how to prevent complications, what to ask their doctor — basically, how to self-manage their diabetes and be their own proponent," says Kuklewski, who has type 1 diabetes.

Most people in the program have been newly diagnosed with type 2 diabetes. The dramatic rise of this chronic disease in the U.S. is reflected in the program's numbers: 400 participants are expected this year — an increase of 35 percent since the program became certified in 2002.

Also provided are education about and services for:

insulin management
nutritional counseling
lab and diagnostic testing
gestational diabetes counseling
insulin pump training
glucose monitoring

Participants typically enter the program upon referral by their doctor, and services are covered by most insurance plans.

For more information, call (616) 394-3270.

HOLLAND HOSPITAL OFFERS TWO SUPPORT GROUPS:
"Living with Diabetes" and "Juvenile Diabetes."
Click here for more information.

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