Pre-diabetes is far more common in America than previously believed

Apr 29 2004

"Pre-diabetes" -- a condition that raises a person's risk of developing type 2 diabetes, heart disease, and stroke -- is far more common in America than previously believed, according to a new HHS estimate released today. About 40 percent of U.S. adults ages 40 to 74 -- or 41 million people -- currently have the condition, which is marked by blood glucose levels that are higher than normal but not yet diabetic. Many people with pre-diabetes go on to develop type 2 diabetes within 10 years.

The new estimate is based on a revised, more accurate definition of pre-diabetes made by an international expert committee of the American Diabetes Association (ADA) and published in Diabetes Care in November 2003. Under previous criteria, it had been estimated that some 20.1 million in this age group had pre-diabetes.

"Every 25 seconds, someone in America is diagnosed with diabetes," HHS Secretary Tommy G. Thompson said. "These latest numbers show how urgent the problem really is. We need to help Americans take steps to prevent diabetes, or we will risk being overwhelmed by the health and economic consequences of an ever-growing diabetes epidemic."

The new definition of pre-diabetes identifies more people who are likely to develop type 2 diabetes, highlighting the importance of preventing this disease. "By identifying people with pre-diabetes, we can encourage them to take preventive measures such as losing weight, becoming physically active and eating a healthy diet, to help keep diabetes and other serious health problems at bay," Secretary Thompson said.

Secretary Thompson announced the new estimate at HHS' 2nd annual Steps to a HealthierUS Summit in Baltimore, where he advocated his program of small, achievable lifestyle steps to achieve better health and avoid chronic disease. Type 2 diabetes is strongly associated with overweight and obesity.

"Research has clearly shown that losing 5 to 7 percent of body weight through diet and increased physical activity can prevent or delay pre-diabetes from progressing to type 2 diabetes," said Dr. Allen Spiegel, director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health within HHS.

On Wednesday, HHS' National Diabetes Education Program (NDEP) launched the first national multicultural diabetes prevention campaign, Small Steps. Big Rewards. Prevent type 2 Diabetes to take action against the diabetes epidemic. The campaign includes motivational tip sheets for consumers as well as print and radio public service ads, tailored for specific high risk groups: African Americans; Hispanic and Latino Americans; American Indians and Alaska Natives; Asian Americans and Pacific Islanders; and adults aged 60 and older.

"Without intervention, one in three children born in the year 2000 will develop diabetes in their lifetime," said Dr. Frank Vinicor, director of the Centers for Disease Control and Prevention's diabetes division. "For some of us, the risk is even higher. If that child is Hispanic and female, she has a one in two chance of developing diabetes in her lifetime. We need to get the word out that type 2 diabetes can be prevented."

Pre-diabetes may be called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.

• IFG is a condition in which the blood sugar level is high (100 to 125 milligrams per deciliter or mg/dL) after an overnight fast but not high enough to be classified as diabetes. (The former definition of IFG was 110 mg/dl to 125 mg/dl.)

• IGT is a condition in which the blood sugar level is high (140 to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not high enough to be classified as diabetes. (The ADA expert committee did not change the definition of IGT.)

The new estimate of people with pre-diabetes is detailed in the latest National Diabetes Fact Sheet, released today by HHS' CDC and NIDDK. The estimates were calculated using data from the 1988-1994 National Health and Nutrition Examination Survey and projected to the 2000 U.S. population.

The National Diabetes Fact Sheet provides up-to-date information about diabetes, its prevalence, incidence, complications and costs to the nation. Overall, about 18.2 million Americans currently have diabetes, with about 1.3 million new cases being diagnosed each year. Most of these individuals - 90 percent to 95 percent - have type 2 diabetes, which is associated with older age, obesity, physical inactivity and ethnicity. The fact sheet is available at www.cdc.gov/diabetes/pubs/factsheet.htm or by calling 1-877-CDC-DIAB (232-3422).