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Doctors Advised to Screen for "Pre-diabetes"


he U.S. Department of Health and Human Services (HHS) estimates that 16 million Americans have “pre-diabetes,” a term coined by HHS and the American Diabetes Association (ADA) to describe the elevated blood glucose levels, also known as impaired glucose tolerance, that often precede type 2 diabetes. Unless people with pre-diabetes make modest changes in their diet and physical activity habits, most will go on to develop type 2 diabetes within a decade.

In March 2002, HHS Secretary Tommy Thompson and ADA President-elect Francine Kaufman, M.D., unveiled the recommendations of an expert panel on pre-diabetes. The panel, which included representatives of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Centers for Disease Control and Prevention (CDC), advises physicians to screen patients who are overweight and age 45 or above for pre-diabetes. The panel also recommends screening adults under age 45 if they are significantly overweight and have one or more risk factors such as a family history of diabetes, low HDL cholesterol and high triglycerides, or high blood pressure.

The panel’s recommendations are based in part on the success of NIDDK’s Diabetes Prevention Program (DPP). This major clinical trial found that reducing dietary fat and calories and increasing physical activity resulted in a 5- to 7-percent weight loss among study participants, which in turn lowered the incidence of type 2 diabetes by 58 percent. “Now that we have shown that we can prevent or delay diabetes, we need to find the people who can benefit,” said panel member Judith Fradkin, M.D., Director, Division of Diabetes, Endocrinology, and Metabolic Diseases, NIDDK. “These new practical recommendations can help.”

Currently, an estimated 17 million Americans have diabetes, nearly 6 million of whom are undiagnosed. Diabetes is the leading cause of adult blindness, kidney failure, and non-traumatic amputations, and a major cause of heart disease and stroke.

More information about diabetes is available from NIDDK’s National Diabetes Education Program online at s

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