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Prediabetes: 50 million metabolic time bombs

By Linda Ciampa
Special to CNN
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(CNN) -- More than 50 million people in the United States may be ticking metabolic time bombs. Many are young. Most have no clue that they are on the verge of developing a potentially devastating disease. They are prediabetics and their numbers are growing.

"This is an epidemic," says Dr. H. James Brownlee, professor and chair of the Department of Family Medicine at the University of South Florida College of Medicine. "I'm like a Baptist preacher saying, 'Folks, we have got to stop waiting.' We have got to get to this earlier."

There are no signs or symptoms for prediabetes, says Brownlee, but it likes to keep company with a host of other bad "stuff." "If you have a little bit of bad cholesterol, if you have a little bit of bad sugar, a little bit of bad blood pressure, things are starting to fall apart," says Brownlee. "Almost all people who have prediabetes go on to have Type 2 diabetes unless they make changes in diet and lifestyle." (Watch how one woman manages her blood sugar. Video )

Type 2 diabetes is the most common form of diabetes. The body either doesn't produce enough insulin to get glucose into the cells or glucose builds up in the blood instead of going into the cells.

Rose Jingozian of Stoneham, Massachusetts, learned she was "on her way" to diabetes a few years ago, quite by accident. A simple blood profile, done at a health spa, found Jingozian had high triglycerides and high cholesterol. Although her fasting blood sugar hadn't reached the prediabetic level of 100, her doctor warned her it was only a matter of time.

With that "wake-up" call and the memory of her mother and grandmother struggling to manage their diabetes, Jingozian has tried to make some changes in her lifestyle. "I'm staying away from as much carbohydrates as possible and eating more protein," she says. "I went out to eat the other day, took the bread off and ate just the hamburger."

Jingozian's efforts seem to be paying off -- she recently lost six pounds -- but one of her main complaints is feeling tired and not motivated to exercise. Brownlee says fatigue is common in prediabetics -- and it sets up a vicious cycle. "Patients will say, 'I know I need to exercise, but I am so tired when I walk in the door at night I just don't have the energy to do it.' "

Brownlee says many of these overweight people actually have sleep disorders, such as sleep apnea, or suffer from depression, which causes them to wake up in the middle of the night. As for the vicious cycle part of it: tired people crave carbohydrates -- the very foods which can worsen prediabetes.

St. John's Wort, a mild, herbal antidepressant can help, Brownlee says. "I encourage people to consider taking 300 milligrams three times a day and be patient. It takes at least a month to feel the benefit." Those with sleep apnea ought to be evaluated by their primary-care physician, he adds.

How else to exit off the diabetes highway? Start by counting your steps. "I wear a pedometer all the time," Brownlee says. "We need 10,000 steps minimal a day. You want to lose weight? 15,000 steps." Take the stairs, he recommends, and when eating, slow down. "I talk fast, I eat fast. And families do that. Slow down. Put your utensil down between bites and use smaller plates so you don't have such big portions in front of you."

Even though diabetes runs in her family, Jingozian has yet to develop the full-blown disease. At 73, she still works an average of four days a week as a nurse because, she says, "It gets you moving."

From her nursing background, she knows prediabetes can harm the heart and circulatory system all on its own. But that's not what's motivating her. "I feel so much better when I watch what I eat and get a little exercise. I can't afford not to pay attention to this."

Linda Ciampa is a registered nurse and freelance health writer.


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