People with prediabetes not taking adequate precautions to avoid diabetes

March 2, 2010

In 2005-2006, almost 30% of the U.S. adult population had prediabetes, but over 90% were unaware of their prediabetes status. Although it is known that diabetes can be prevented or delayed among adults at high risk through modest weight loss and increased physical activity, a study published in the April 2010 issue of the American Journal of Preventive Medicine revealed that only about half of U.S. adults with prediabetes reported that in the past year they tried to lose weight or exercise more.

Researchers from the Division of Translation of the , Emory University, and the National Institute of Diabetes and Digestive and Kidney Diseases examined whether people with prediabetes are adopting preventive measures and what demographic factors might influence these behaviors. Survey data from 1402 adults with prediabetes who participated in the 2005-2006 National Health and Nutrition Examination Survey (NHANES) was analyzed. Survey participants were interviewed and given a fasting plasma glucose test (FPG) and an Oral Glucose Tolerance Test (OGTT).

All survey participants were asked whether in the past 12 months, they had: (1) tried to control or lose weight, (2) reduced the amount of fat or calories in their diet, and (3) increased physical activity or exercise. They were also asked whether they had been told by a doctor or other health professional in the past 12 months to perform each of these three risk reduction behaviors. In addition, they were asked if they had been screened for diabetes or high blood sugar in the past 3 years. Demographic factors such as gender, age, race/ethnicity, family history, and education level were also self-reported.

The researchers found that in 2005-2006, 29.6% of U.S. adults aged ≥20 years had prediabetes. Only 7.3% of those with prediabetes reported that they had been told that they had a prediabetes condition. Less than half (47.7%) of adults with prediabetes reported a test for diabetes or high in the past 3 years.

Although adults with and without prediabetes were similar in race and ethnicity, adults with prediabetes were more likely than those without prediabetes to be male, older, and have lower educational attainment. They were also somewhat more likely to report that an immediate family member had diabetes. Also, adults with prediabetes were more likely to have higher levels of well known cardiovascular disease risk factors, including higher mean weight, waist circumference, systolic blood pressure, and triglycerides, as well as a higher prevalence of hypertension.

Writing in the article, the team of investigators led by Linda Geiss of the Division of Diabetes Translation, Centers for Disease Control and Prevention, states, "Reversing the growing diabetes problem will require multiple levels of interventions, including promotion of healthy lifestyles and increased availability of evidence-based community prevention programs for people at high risk. More efficient identification and awareness of prediabetes is a key first step to implementing these changes."

More information: The article is "Diabetes Risk Reduction Behaviors Among U.S. Adults with Prediabetes" by Linda S. Geiss, MA, Cherie James, MSPH, Edward W. Gregg, PhD, Ann Albright, PhD, RD, David F. Williamson, PhD, and Catherine C. Cowie, PhD. The article appears in the American Journal of Preventive Medicine, Volume 38, Issue 4 (April 2010).

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