Doctors increasingly focus on treating prediabetes

DALLAS — Blake Brown tried not to cry when his doctor told him he had prediabetes in February, the month he turned 10.

"It scared me," Blake says softly in his Mesquite, Texas, home, sitting near family pictures that included his father, who also struggled with his weight and died of a heart attack at 44, when Blake was 3 years old.

With prediabetes, people have blood glucose levels that are higher than normal, but not high enough to be classified as diabetes. Ten years ago, most doctors would not have alarmed patients with the term, says Dr. Jeffrey A. Astbury, an internist on the medical staff at Baylor Medical Center at Waxahachie, Texas, who treats prediabetes in his private practice.

"In the past, we referred to it as borderline blood sugars or impaired glucose tolerance or impaired fasting glucose," Astbury says. "Now the term prediabetes is preferred because it raises concern and provides a teachable moment."

The new language is part of a push to spur patients to action amid a growing concern about diabetes. Nearly 24 million adults in the United States have the disease, and 57 million have prediabetes, with one out of three children and one out of two minority children on track to get diabetes, according to the American Diabetes Association.

And as many as one-third to one-fifth of U.S. adults could have diabetes by 2050 unless current trends change, according to a study just released by the U.S. Centers for Disease Control and Prevention.

Unlike Type 1 diabetes, an insulin-dependent condition with no known relation to weight or lack of exercise, obesity and inactivity are fueling the rising levels of Type 2 diabetes, in which the insulin the body produces becomes less efficient at moving sugar out of the bloodstream.

The word prediabetes scared Blake and his mother, Karen Brown, 50, into reaching out to the Cooper Clinic's Healthy Habits for Kids program. Despite Blake's initial concern that a nutritionist sounded scary, they began working with dietitian Patty Kirk, the clinic's co-director of nutrition.

Soon Blake started looking forward to their weekly meetings as they hammered out an eating and exercise program that would work with his likes and interests, even taking into account the snacks he wanted while his mother was working and he was at day care.

Dr. Heidi Shea, an endocrinologist practicing in Dallas and Plano, says this early identification of prediabetes and intervention is exactly what is needed, because the best time to help people is before they get diabetes.