PRE-DIABETES

Soon after the term pre-diabetes was coined – with lifestyle interventions the only recommended treatment – the maker of Avandia, a medication for type 2 diabetes partly funded a trial which the drug was found to reduce the risk of the disease in people with borderline blood sugar levels “that prompted aggressive marketing of the drug for prevention, and some physicians responded by treating people who had not yet developed diabetes, says Victor Montori, M.D., a professor of medicine and diabetes specialist at the Mayo Clinic, in Rochester, Minn. Last year the FDA restricted the use of Avandia due to concerns it would cause a heart attack or stroke.

Who has it: People with a fasting blood sugar level of 100 to 125 milligrams per deciliter. Risk factors include being 45 or older, being overweight or physically inactive, not having a family history of diabetes.

How serious is it? Most people with pre-diabetes develop the full-blown disease within 10 years.

How to reduce your risk: Lose 5 to 10 percent of your body weight through diet and moderate exercise, such as brisk walking, 30 minutes a day, five days a week.

How to avoid overtreatment: If you have pre-diabetes, you should be checked for diabetes every one to two years, according to the Amercan Diabetes Association. Aim for a fasting blood glucose level close to 110 mg/dl, or lower. No drug is approved by the FDA to treat pre-diabetes, or prevent pre-diabetes, but only by people who are at very high risk for the disease, or prevent pre-diabetes. The ADA says that metformin might be considered for use in preventing type 2 diabetes but only by people who are at very high risk for the disease, have a BMI of at least 35, and are under age 60. Other drugs that have delayed the onset of Type 2 diabetes have side effects or haven’t shown long-lasting benefit.