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New Diabetes Screenings Urged for Older Citizens

The Nation

Health: Renaming a type of high blood sugar comes as stepped-up efforts are announced to reduce burgeoning cases.

March 28, 2002|MEGAN GARVEY | TIMES STAFF WRITER

WASHINGTON — Overweight Americans age 45 and older should be screened regularly for a condition now being called "pre-diabetes" and take steps, if needed, to prevent the full-blown onset of the potentially devastating disease, top U.S. health officials said Wednesday.

"Every year a person can live free of diabetes means an added year free of the pain, disability and medical costs of this disease," Health and Human Services Secretary Tommy G. Thompson said.

The renaming of a type of high blood sugar previously called "impaired glucose tolerance" came as Thompson announced stepped-up efforts to reduce what health care experts view as an epidemic of diabetes, with cases tripling in the last 30 years.

Health officials believe that using the term "pre-diabetes" might help to focus attention on the serious risk many individuals are facing. The condition often goes undetected and poses increased risk for cardiovascular disease, officials said.

At least 16 million Americans age 40 to 74 are estimated to fall into the pre-diabetes category, in addition to 17 million already suffering from Type 2, or adult-onset, diabetes.

Health officials said those younger than 45 who are overweight and have other risk factors--such as African American, Latino or Native American heritage or a family member with diabetes--should consult with a doctor about getting screened.

Unlike childhood-onset, or Type 1, diabetes, Type 2 usually develops in adults whose bodies can no longer properly turn blood sugar into energy. It often is brought on by obesity. As the disease progresses, patients are at risk for blindness, kidney failure, amputation of limbs because of inadequate blood flow or infection, and heart attack.

The good news, Thompson and diabetes experts said Wednesday, is that recent studies indicate that the disease can be delayed--and perhaps even stopped altogether--by simple diet changes, modest weight loss and regular moderate exercise.

National Institutes of Health research has shown that such lifestyle changes reduce by nearly 60% the number of pre-diabetes sufferers who eventually develop the more serious disease.

Dr. Frank Vinicor, director of the diabetes program at the federal Centers for Disease Control and Prevention in Atlanta, warned that, without aggressive steps to reduce rates of the disease, the medical system "could soon be overwhelmed."

The screening procedures recommended Wednesday by HHS, CDC and NIH, however, are not covered by Medicare or Medicaid, officials said. Minority communities, considered to be among the most at risk, also have higher numbers of uninsured individuals, another hurdle to preventive care.

Thompson said he planned to work with insurance companies, employers and others to convince them that the tests, which cost about $25 each, would be well worth the expense.

Asked whether the government's message of better nutrition and a healthier lifestyle could compete with constant advertisements for fast food, Thompson conceded that the effort would not be easy.

"We spend way too little," he said when asked about how the government's efforts compare with those of a company such as fast-food giant McDonald's.

"The truth of the matter," Thompson said, "is that in America we spend a lot of money once people get sick trying to get them better again. If we focused on prevention, we'd all be better off."

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