Only about one in eight people with so-called pre-diabetes, often a precursor to full-blown disease, know they have a problem, a U.S. study found.
Lacking awareness, people with elevated blood sugar level were also less likely to make lifestyle changes such as getting more exercise, losing excess weight or eating less sugary foods that might prevent them from developing full-blown diabetes.
Prediabetes – which affects one-third of Americans and more than 5.7 million Canadians – occurs when blood sugar is higher than normal, but not yet high enough to be considered diabetes. Without weight loss and exercise, prediabetes progresses to Type 2 diabetes in as many as 30 per cent of cases within five years.
The new study showed that individuals with pre-diabetes who were aware of this diagnosis were more likely to engage in recommended healthy lifestyle changes.
Globally, about one in nine adults have diabetes, and the disease will be the seventh leading cause of death by 2030, according to the World Health Organization.
The majority of people have Type 2, which happens when the body can't properly use or make enough of the hormone insulin to convert blood sugar into energy.
Average blood sugar levels over the course of several months can be estimated by measuring changes to the hemoglobin molecule in red blood cells. The hemoglobin A1c test measures the percentage of hemoglobin – the protein in red blood cells that carries oxygen – that is coated with sugar, with readings of 6.5 percent or above signaling diabetes.
But A1C levels between 5.7 percent and 6.4 percent are considered elevated, though not yet diabetic.
To gauge awareness of this heightened diabetes risk among people with prediabetes, researchers weeded out people who said they already had the disease. Then, they reviewed A1c test results for the rest.
Out of 2,694 adults with test results showing elevated A1c, only 288 people were aware of their status.
People who were aware of their condition were about 30 percent more likely to exercise and get at least 150 minutes of moderate activity each week.
They were also about 80 percent more likely to attempt weight loss and to have shed at least 7 percent of their body weight in the past year.
Health care providers need to tell patients with elevated blood sugar that they don’t meet the criteria for diabetes but they are at greater risk, which can be a challenging concept to get across some experts say. This challenge could explain the low awareness.
Some patients may also have been tested for diabetes using another measurement known as an oral glucose tolerance test, which can get different results than screening for A1c.
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