Pre-diabetes on the rise, but lifestyle changes may help ward off the disease
Teresa Van Bladel of Lake Villa is taking aim at a potential killer.
She lost a very dear friend at age 38 to cardiovascular disease related to diabetes and is determined not to let the chronic disease win in a battle with her. Van Bladel, 44, has reason to be concerned. Two years ago she was diagnosed with pre-diabetes, a condition that can lead to Type 2 diabetes and heart disease.
American Diabetes Association experts say nearly 86 million Americans age 20 and older had pre-diabetes in 2012, up from 79 million just two years earlier.
Typified by higher than normal blood glucose levels, pre-diabetes (sometimes called impaired glucose tolerance or impaired fasting glucose) places individuals like Van Bladel at a higher risk for developing Type 2 diabetes and cardiovascular disease.
“I'd been feeling very tired, especially after eating foods classified as carbohydrates,” recalls Van Bladel, who works in accounts payable at Anixter International and was familiar with diabetes due to her ex-husband's experience. “I did some research and began to wonder if I, too, could have the disease.”
Van Bladel's concerns were validated after a visit to her doctor and a simple blood test, showed she had pre-diabetes. Since that time, she's changed her diet, began counting carbohydrates and restricting calories, lost 10 pounds in two months, began walking 20 minutes at lunch each day and walking her two dogs after work. Van Bladel recruited an entire team of Anxiter employees to walk and sponsor the Step Out Walk to Stop Diabetes in Buffalo Grove this fall, recently began testing her blood glucose levels twice a day and taking the prescription oral medication, Metformin, to help in her fight against Type 2 diabetes.
“There's no clear symptoms of pre-diabetes, so you may not even know you have it,” she cautions.
According to the American Diabetes Association, nearly half of American adults like Van Bladel have either pre-diabetes or diabetes, raising their risk of heart attacks, blindness, amputations and cancer.
A recent analysis of 16 studies involving almost 900,000 people worldwide, published in the current issue of the journal Diabetologia, shows pre-diabetes not only sets the stage for diabetes but also increases the risk of cancer by 15 percent
Van Bladel's determination is on target, says Dr. George Motto, a board-certified endocrinologist who serves as the founder and medical director at the Metabolism, Weight & Lifestyle Institute, Ltd., Arlington Heights.
Lowering Type 2 diabetes risk
“You don't necessarily develop Type 2 diabetes if you have pre-diabetes,” Dr. Motto says. “However, for some people with pre-diabetes, early treatment can actually return blood glucose levels to the normal range.”
Research shows there are things you can do to lower your risk for Type 2 diabetes, the most common form of diabetes diagnosed in millions of Americans.
According to the experts, many are unaware they have the disease or are at high risk for developing diabetes. In Type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin, a hormone necessary for the body to use glucose for energy.
While the diagnosis of Type 2 diabetes used to be considered a disease of aging, it's not uncommon for today's teens and tweens to be diagnosed.
Due in part to a more sedentary lifestyle and changes in diet, it's becoming increasingly common to see overweight suburban children — some as young as 5, 6 and 7 years of age — at increased risk of developing Type 2 diabetes by the time they reach their 10th or 11th birthday.
Among Dr. Motto's recommendations to forestall or avoid the onset of Type 2 diabetes: cut back on calories and saturated fats; exercise at least 30 minutes a day, five days a week; and lower your body weight.
“Don't worry if you can't get to your ideal body weight,” says the endocrinologist; even 10-15 pounds can make a difference. “I remember my father, Salvatore Motto, a pharmacist, saying when I was in grammar school and growing up on Chicago's west side that we're killing ourselves with our fork. My dad was indeed ahead of his time. Look how society has changed in the past 50 years as we've become more sedentary, less active throughout our day, and eating more.”
In the years since childhood, Dr. Motto says an epidemic of lifestyle-related overweight, obesity and physical unfitness has resulted in dramatic increases in diabetes, high blood fats, hypertension, osteoarthritis, sleep apnea, stroke, and diminished quality of life.
“The strongest predisposition to getting Type 2 diabetes is if you have an immediate family member with the disease,” he cautions. “As we age, people simply stop producing enough insulin to meet needs.”
Dr. Motto says by reducing 8 to 10 percent of body weight and exercising for 150 minutes a week, individuals are able to slow disease progression.
“There's no magic pill,” he says. “It's all about reducing total caloric intake and increasing daily physical activity. We need to buy into the truth that we are simply eating too much and not moving enough. Look at trained athletes and follow their example of making exercise a significant part of a healthy new lifestyle.”
The voice of experience
Greg Eischen, a 53-year-old Plainfield resident says making those lifestyle changes literally saved his life.
“About 20 years ago when I was diagnosed with high cholesterol, it didn't faze me — I took a pill,” recalls the former Downers Grove purchasing manager. “A few years after that, high blood pressure developed and I took another pill. Then several years later, my triglycerides were tested at 765 (normal is less than 150). I took a pill, then another and couldn't get them under control. My doctor and I determined it was genetics. Finally, in 2008 I was diagnosed with diabetes and added yet another pill.”
“My A1C was 8.0, I had Type 2 diabetes, and somewhere along the line as part of a pre-op physical exam for a minor elective surgery, I learned I had had a heart attack,” Eischen says. He shaved his head bald and kept it that way for three years to help put a face to the disease.
As a young adult in his late 40s, Eischen had become obese, tipping the scales at more than 300 pounds.
“Sitting behind a desk, unhealthy eating and lack of any exercise made me a statistic,” he said. In addition, he had the deadly trilogy of high blood pressure, high cholesterol and diabetes. “Add to that obesity and abnormally high triglycerides and it's a recipe for a heart attack or death.”
For Eischen, diabetes hit hard.
“For some reason, this one struck a nerve,” he notes. “I'm sure it was the fact that my dad battled diabetes. He had eye problems, foot problems and ultimately heart issues due to the disease's devastating toll on his body. It also could have been that at age 47, I was on five maintenance medications and would be for the rest of my life.”
Eischen started a diet and exercise program on his own, joined a local gym, Hometown Fitness in Plainfield, and in about a year was able to lose 25 pounds.
“But I hit that wall, the one that causes people to give up in frustration,” he says. “I began to work with a personal trainer, Anthony Liggammari, who taught me the proper way to exercise, how building lean body mass would increase my body's metabolism, and how I should eat for nutrition as well as enjoyment.
In a little over a year, Eischen lost another 75 pounds and was able to eliminate the need for all five medications.
“That was never a goal starting out, but as I saw my numbers starting to go down and my fitness increased, it became one,” Eischen says. Recently his doctor told him he is no longer diabetic.
“After two years of normal A1C numbers without medication, I have my diabetes fully under control,” boasts the father of two grown children, Bree, 23, and Alex, 20, who notes that along the road to health, he made significant life changes.
“As a family, we decided my health was more important than my career,” Eischen says. After discussions with his wife, Janeen, he returned to school to learn how to help others exercise and make healthy lifestyle choices. “I changed my career and became a personal trainer at Hometown Fitness. I wanted to pay forward what Anthony gave me. I now work with overweight adults and those with health issues such as diabetes and heart disease. I made exercise a necessity, like eating, sleeping and breathing.”
Today Eischen lifts weights, does strength training, but also incorporates cardiovascular activity several times a week. Biking is his cardio activity of choice.
“It's important to find exercise you enjoy,” says Eischen, who this year serves on the committee helping to plan the American Diabetes Association's Tour de Cure biking event — set for Sunday, June 14, 2015, in Aurora.
“Treadmills and elliptical machines don't do it for me. Running was a bust. I found biking was my workout choice and also my outlet. I can go out solo for miles, but I also enjoy a social ride with friends. My favorite are my rides with my wife.”
Investing in healthy lifestyles
The physical and economic costs of diabetes are lifelong, according to Dr. Przemyslaw Lastowiecki, a board-certified endocrinologist affiliated with Alexian Brothers Medical Center, an organization whose diabetes program recently was recognized as one of the top programs in the area by U.S. News Magazine.
“I often tell my patients that making an investment in exercise and making dietary changes are like paying taxes on a CD or bank savings note,” says Dr. Lastowiecki. “What you put in now can make a big difference in your future, ultimately saving you from tissue disease, blindness, cardiovascular disease, kidney disease and amputation. Diabetes is a continuum, beginning with pre-diabetes in the early years and for many, debilitating complications down the road.”
He cites findings of the Diabetes Prevention Program, a major 2002 multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug, Metformin, could prevent or delay the onset of Type 2 diabetes in study participants.
“With pre-diabetes becoming more common in the United States, we're finding those with pre-diabetes are likely to develop Type 2 diabetes within eight to 10 years, unless they take aggressive steps to prevent or delay diabetes. The study found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes. Taking Metformin also reduced risk, although less dramatically.”
Dr. Lastowiecki concludes it's not the pill that packs the biggest punch, but the lifestyle changes, weight loss and increased exercise.
“It's my best advice for patients with pre-diabetes and a prescription I'm happy to put in writing,” he says.
For additional information on pre-diabetes, diabetes, its warning signs and management, call the American Diabetes Association at (800) DIABETES, or visit diabetes.org.
Diabetes Warning Signs
The following symptoms are typical. However, some people with Type 2 diabetes have symptoms so mild they go unnoticed:
<b>Type 1 diabetes</b>
(Symptoms usually occur suddenly)
• Frequent urination
• Excessive thirst
• Unusual, extreme hunger
• Dramatic weight loss
• Irritability
• Weakness or fatigue
• Dehydration
• Nausea and vomiting
<b>Type 2 diabetes</b>
(Symptoms usually occur gradually)
• Any of the type 1 symptoms
• Recurring or hard-to-heal skin, gum or bladder infections
• Drowsiness
• Blurred vision
• Tingling or numbness in hands or feet
Source: American Diabetes Association
<b>Fast facts … Did you know?</b>
• Almost 30 million children and adults in the United States have diabetes.
• 86 million have pre-diabetes, 37 percent of all U.S. adults age 20 and older have pre-diabetes.
• 1.7 million Americans are diagnosed with diabetes each year.
• Nearly 10 percent of the entire U.S. population has diabetes, including more than 25 percent of seniors.
• As many as one in three American adults will have diabetes in 2050 if present trends continue.
• The economic cost of diagnosed diabetes is the U.S. is $245 billion per year.
Source: American Diabetes Association, 2014.