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Just because we didn't focus on pre-diabetes doesn't mean you shouldn't

October 26, 2009 |  1:51 pm

TomatoesReader Barbara Kaplan of Los Angeles wasn't satisfied with today's special Health section on diabetes treatment. She writes:

"Although I applaud your efforts in heightening awareness of diabetes, especially type 2, it is unfortunate that you failed to mention pre-diabetes, which usually precedes a formal diagnosis of the disease. A fasting blood sugar of 126 or an A1C of 6.5 generally occur after months, years or even decades of readings that, albeit lower, but still can cause considerable damage to the body. If a person is aware of the fact that he or she is on the road to full-blown diabetes, early intervention can often prevent further deterioration. 
 
"Also, your emphasis on overweight and obesity could cause people of normal weight to ignore symptoms. There are many non-obese type 2 diabetics, and even more non-obese pre-diabetics. For example, I have been pre-diabetic for at least 5 or 6 years despite a BMI of 23. My A1C is 6.1, which is lower than the criteria you suggest but still too high.  I have never had a fasting blood sugar over 110, but that too is above normal. Fortunately, because of my family history, I periodically used a relative's meter to test myself and therefore caught my condition early. I now use Metformin to hopefully arrest progression.  However, my brother wasn't diagnosed until after his fasting levels rose above 126.  By that time he had neuropathy and other symptoms which were irreversible. I also know people who, by the time they were diagnosed, were ready for toe amputations and other drastic measures. Several of these folks were quite slender.
 
I hope you can publish an update to today's section in a future edition. Pre-diabetes is a potentially serious condition that can be controlled or even reversed."

Consider it done, Barbara. And because you've said it so well, we'll simply add these links to more information on pre-diabetes ...

- the American Diabetes Assn. The information includes risk factors for the condition, prevention tips, frequently asked questions about it and more.

- the Centers for Disease Control and Prevention. This site offers not just general facts, but useful specifics on tests, diagnostic values and screening values.

- the National Diabetes Information Clearinghouse. This overview includes a useful heads up about ongoing research, plus findings from the Diabetes Prevention Program.

-- Tami Dennis

Photo: Eat right, exercise ... it's good advice for everyone; and the naturally thin don't get a pass.

Credit: Anne Cusack / Los Angeles Times

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