Type 2 Diabetes and Pre-Diabetes

Diabetes is a disorder that affects the way your body uses digested food for growth and energy. Normally, the food you eat is broken down into glucose. The glucose then passes into your bloodstream, where it is used by your cells for growth and energy. For glucose to reach your cells, however, insulin must be present. Insulin is a hormone produced by your pancreas, a hand-sized gland behind your stomach.

Most people with type 2 diabetes have two problems: the pancreas may not produce enough insulin, and fat, muscle, and liver cells cannot use it effectively. This means that glucose builds up in the blood, overflows into the urine, and passes out of the body—without fulfilling its role as the body's main source of fuel.

About 18.2 million people in the United States have diabetes. Of those, 13 million are diagnosed and 5.2 million are undiagnosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness in American adults. People with diabetes are also two to four times more likely than people without diabetes to develop heart disease.

Pre-diabetes, also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), is a condition in which your blood glucose (blood sugar) levels are higher than normal but not high enough for a diagnosis of diabetes. Having pre-diabetes puts you at higher risk for developing type 2 diabetes. If you have pre-diabetes, you are also at increased risk for developing heart disease.

You are more likely to develop type 2 diabetes if

    * you are overweight
    * you are 45 years old or older
    * you have a parent, brother, or sister with diabetes
    * your family background is African American, American Indian, Asian American, Hispanic American/Latino, or Pacific Islander
    * you have had gestational diabetes or gave birth to at least one baby weighing more than 9 pounds
    * your blood pressure is 140/90 or higher, or you have been told that you have high blood pressure
    * your HDL cholesterol is 35 or lower, or your triglyceride level is 250 or higher
    * you are fairly inactive, or you exercise fewer than three times a week

In a cross-section of U.S. adults aged 40 to 74 tested during the period 1988 to 1994, 33.8 percent had IFG, 15.4 percent had IGT, and 40.1 percent had pre-diabetes (IGT or IFG or both). Applying these percentages to the 2000 U.S. population, about 35 million adults aged 40 to 74 would have IFG, 16 million would have IGT, and 41 million would have pre-diabetes. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes. The results of the Diabetes Prevention Program showed that modest weight loss and regular exercise can prevent or delay type 2 diabetes.