Many of the health risks associated with impaired glucose tolerance (IGT) are the same as those for diabetics, but studies have shown that diet and exercise can reverse lGT.
According to Dr. Neil Schaffner, assistant professor of medicine at the University of Alabama at Birmingham, there are 40 to 80 million Americans who have either diabetes or impaired glucose tolerance (IGT), and about 30 percent of those are undiagnosed.
“The Centers for Disease Control predicts that one in three people among the general population of the United States will get diabetes within the next 10 to 15 years,” he said.
“lGT is simply pre-diabetes. A person’s abnormal blood sugar values are not high enough to be classified as diabetic. But people with lGT have the same cardiovascular risk as people with full-blown diabetes,” he said.
But the good news is that two simple lifestyle changes — diet and exercise — will significantly delay diabetes in the more than 10 million Americans who are at high risk of getting the disease, a National Institutes of Health-sponsored study shows.
According to Health and Human Services Secretary Tommy G. Thompson, Diabetes Prevention Program (DPP), a major clinical trial, compared diet and exercise to treatment of lGT with the drug Metformin.
The study involved 3,234 overweight people with IGT, ages 25–85. Their average body mass index (BMI) was 34. BMI is a person’s weight in kilograms divided by height in meters, squared. An easy-to-understand BMI chart can be found at www.consumer. gov/weightloss/bmi.htm. Generally, a BMI more than 25 is considered overweight, while beyond 30 is scored as obese; both designations put a person at higher risk for many diseases, including diabetes.
Within three years after the study concluded, 29 percent of the untreated group developed diabetes, 22 percent of those taking the drug Metformin developed diabetes, but only 14 percent of those engaged in the diet and exercise modification group of the study developed
diabetes.
“In view of the rapidly rising rates of obesity and diabetes in America, this good news couldn’t come at a better time,” Thompson said.
It is unknown exactly how many years proper diet and exercise can delay diabetes in people most prone to it, but diet and exercise can delay the disease or even prevent it.
“Every year a person can live free of diabetes means an added year of life free of the pain, disability and medical costs incurred by this disease,” said Dr. Allen Speigel, director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (Bethesda, Md.), which was the sponsoring organization for the study.
“The DPP findings represent a major step toward the goal of containing and ultimately reversing the epidemic of Type II diabetes in this country,” he said.
NIDDK says that about 20 million people in America have impaired glucose tolerance and that about lO million of those are at high risk for getting diabetes.
The line between having IGT and being diabetic is distinct, in spite of a popular phrase that is loosely thrown around in our society — “borderline diabetic.”
“There is no such thing as borderline diabetes. Even people with impaired glucose tolerance must take the time to start action now,” said Pam Green, assistant director of the Baptist Health Diabetes Center in Montgomery. Green said nondiabetics who are told by their doctors that they have IGT should take it seriously and ask what the actual test numbers are. A major change in diet and lifestyle has been proven to greatly reduce the chance that a person with IGT will ever get diabetes, but these changes must be followed as meticulously as the most conscientious diabetic follows his or her routine.
According to the Centers for Disease Control and Prevention in Atlanta, the causes of Type I (Juvenile) diabetes appear to be much different from those for Type II diabetes. The appearance of Type I diabetes is suspected to follow exposure to an “environmental trigger,” such as a virus, stimulating an immune attack against the beta cells of the pancreas (that produces insulin).
Type II diabetes often shows up in people whose families have a history of it. Type I is not as closely tied to this genetic predisposition. However, people with no family history of diabetes of either kind can and do get the disease.
Though Type II is closely linked to obesity, not all diabetics are overweight. In fact, some Type I diabetics are rather slim and even underweight when diagnosed.
The International Diabetes Federation says diabetes is more prevalent in the developed countries of the world, and nutritionists cite convenience diets and food processing as major reasons that people in developed countries get diabetes.
Jennie Brand-Miller is associate professor of human nutrition in the department of biochemistry’s human nutrition unit at the University of Sydney, Australia. In her book, “The Glucose Revolution Life Plan,” Miller said the high-speed roller mills coming in the Industrial Revolution of the 19th century made possible the production of fine white flour, resulting in soft breads, cakes, doughnuts and corn flakes.
But prior to this, grains were ground between stones, keeping high levels of fiber intact. This meant they were slowly digested and absorbed by the human body. Consequently, blood sugar levels didn’t rise quickly after eating.
“Our ancestors ate most of their carbohydrates like this, including fruits, vegetables, beans and whole-grain cereal — all sources of carbohydrates with low glycemic index values,” she said. The glycemic index ranks foods by how much they cause a person’s blood sugar to rise within two to three hours after eating.
“Our modern Western diet tends to be based on these quickly digested carbohydrates (from highly processed grains), which result in much greater rises in blood sugar and insulin levels than most of our bodies have evolved to cope with. As a result, many of us now suffer from diseases such as diabetes, heart disease and obesity in epidemic proportions,” Brand-Miller writes.
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