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Recognizing Prediabetes: Helping Patients Change the Path to Type 2 Diabetes

by R. Keith Campbell Rph, FAADE, CDE

It is estimated that there are 79 million people in the United States with a condition known as PREDIABETES. People who develop type 2 diabetes seem to have a number of characteristics that predispose them to eventually being diagnosed. Pharmaceutical manufacturers that have an interest in diabetes would love to have a product they could offer to individuals with prediabetes that would prevent them from developing diabetes – it would obviously be a huge money maker for them.
Studies are being conducted to see if any of the medications that are approved for type 2 diabetes could indeed be used to postpone the diagnosis of type 2 diabetes for this population.

The following characteristics in an individual will more than likely put the person at a higher risk of developing type 2 diabetes: being overweight; not exercising; having a family history of diabetes; having high blood pressure or high blood lipids; being Native-American, African-American, Spanish speaking or Pacific-Islander; having given birth to a child over 9 pounds or being born with a birth weight of over 9 pounds. Individuals with any of these characteristics should be frequently evaluated for type 2 diabetes. The sooner one is diagnosed and treated, the better.

So what can be done to prevent those with prediabetes from being diagnosed with type 2 diabetes? The answer is obvious for some of the characteristics: EAT less, EXERCISE more, get off of the couch and watch less TV or play fewer video games. Exercise at least 30 minutes a day. One cannot change their family genes or heritage, but lifestyle changes can be made to make an impact on some of the characteristics such as excessive weight, high blood pressure and inactivity.

Now that prediabetes is recognized, many diabetes expert health care providers are not only investigating if a medication could be prescribed, but some are actually prescribing medications. For example: normalizing blood pressure and blood lipids may be helpful. Although it is off-label to do so, some health care providers are prescribing medications already approved for type 2 diabetes like metformin, pioglitazone, GLP-1 agonists or DPP-4 inhibitors, or a combination of the drugs in low doses. I would bet that the new weight loss drugs recently approved by the FDA will also be used in patients with prediabetes. It is hoped that knowing that they are predisposed to getting diabetes will motivate patients and health care providers to attempt to prevent type 2 diabetes. All of us could eat more nutritious and lower calorie diets, not smoke, drink less and exercise more while we are waiting for the approval of the perfect drug to treat prediabetes.

About The Author

R. Keith Campbell RPh, FAADE, CDE is a leader in the field of diabetes, named the “Outstanding Health Care Educator in the Field of Diabetes in the U.S.” by the American Diabetes Association, having published more than 650 articles, serving on numerous boards (including the American Association of Diabetes Educators), and co-developing the popular CADD ambulatory infusion pump.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of DiabetesProductSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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