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New Recommendations for Prediabetes

Doctors Recommend Lifestyle Changes and Medication If Needed: Don't Wait Until It Becomes Diabetes
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WebMD Health News

July 23, 2008 -- If you're one of the estimated 57 million people in the U.S. with prediabetes, an expert medical committee has some advice for you.

The committee, assembled by the American College of Endocrinology and the American Association of Clinical Endocrinologists, has been meeting in Washington, D.C., for the last two days talking about prediabetes.

Here are their recommendations for dealing with prediabetes:

Don't blow it off. In prediabetes, blood sugar levels are above normal but not high enough to be classified as diabetes -- yet. But prediabetes isn't harmless; it makes diabetes (and its many complications) more likely. And it's a risk for your heart right now.

The bottom line: Prediabetes is an immediate risk and a shadow hanging over your future health. So get aggressive about dealing with it now. Don't wait until it gets worse.

Focus on lifestyle. "Lifestyle is the first way to go" in dealing with prediabetes, committee member Yehuda Handelsman, MD, FACP, FACE, medical director of the Metabolic Institute of America, said today at a news conference about the committee's prediabetes recommendations.

Here are the steps the committee wants you to take:

  • Lose 5% to 10% of your body weight -- for good.
  • Get 30-60 minutes of moderate-intensity physical activity at least five days per week.
  • Eat low-fat diet with adequate dietary fiber.
  • To lower blood pressure, cut back on sodium and don't drink too much alcohol.
  • Take aspirin, unless you have a medical reason not to (ask your doctor first).
  • Get your blood pressure and cholesterol down to the levels recommended for diabetes patients.

Take medication, if needed. If lifestyle isn't enough to reduce your risk of diabetes and heart disease, medications may help. But you'll still need to persist with the healthy lifestyle.

Don't get hung up on numbers. The blood sugar benchmarks for diagnosing diabetes are "somewhat arbitrary," says Alan Garber, MD, PhD, FACE, the committee's chairman and a professor at Baylor College of Medicine in Houston. If your blood sugar numbers are outside of the normal range, that's enough of a cue to take action.

The committee also called for further research to find out which prediabetes patients are at the highest risk, and to study drug treatment for prediabetes. The committee's work was sponsored by various drug companies.

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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