Guidelines urge testing middle-aged people to prevent `pre-diabetes' from becoming full-blown diabetes

WASHINGTON (AP) _ Most middle-aged people should be tested during their next visit to the doctor to find if they have ``pre-diabetes,'' a type of high blood sugar that puts them at superhigh risk

Thursday, March 28th 2002, 12:00 am

By: News On 6

WASHINGTON (AP) _ Most middle-aged people should be tested during their next visit to the doctor to find if they have ``pre-diabetes,'' a type of high blood sugar that puts them at superhigh risk of getting full-blown diabetes, say new guidelines.

Almost 16 million Americans have pre-diabetes, the government announced Wednesday. It said, however, that simply walking 30 minutes a day and dropping a little weight can delay, if not prevent, onset of illness. But first, those people must learn they're at risk.

``Most people with pre-diabetes don't know they have it,'' said Judith Fradkin of the National Institutes of Health. ``The important thing is to find it so you can treat it.''

Some 17 million Americans have diabetes, 8 percent more than previously estimated, the government announced. The updated figure reflects new census data.

Some people are born with diabetes. But most have Type 2 diabetes, an illness that develops, often in middle age, when their bodies lose the ability to turn blood sugar into energy.

It is a leading cause of blindness, kidney failure, amputations and heart disease and kills 180,000 Americans each year. Proper therapy can ease those complications, yet experts say one-third of diabetics do not know the disease is festering silently in their bodies.

In addition, doctors have long known that a condition called impaired glucose tolerance, in which blood sugar levels gradually rise, was an early warning sign of impending diabetes. But because diabetes screening is not routine, it was not known how many people have it or how to alert them to take steps to prevent the full-blown disease.

Wednesday's new data estimates 16 million Americans over age 40 have impaired glucose tolerance, which the government renamed pre-diabetes to make it easier for people to understand.

New guidelines recommend that millions of middle-aged people get tested during their next regular doctor visit to see if they have either pre-diabetes or the full disease.

According to the guidelines, from the American Diabetes Association and the NIH:

_Everyone 45 or older should consider getting tested. Testing is strongly recommended if those people are overweight.

_Doctors should consider testing younger adults if they are significantly overweight and have another risk: a diabetic relative; bad cholesterol; high blood pressure; diabetes during pregnancy or gave birth to a baby bigger than 9 pounds; or belong to a racial minority group.

_If the test is normal, repeat it every three years.

If the test finds that the patient has pre-diabetes, a major study last year found that walking 30 minutes a day and dropping about 15 pounds can cut in half the risk of getting the disease.

``We're talking about significant benefits that can be derived from modest exercise,'' Health and Human Services Secretary Tommy Thompson said. ``You don't have to be working up a big sweat in the gym or become a long-distance runner to gain the benefits of exercise.''

Taking a daily pill called metformin also reduced the risk by almost a third in that study. But the new guidelines conclude there is not enough data on the benefits and risks and thus do not recommend routine preventive medication.

The guidelines are published in the April issue of the journal Diabetes Care.