HHS Issues New ‘Pre-Diabetes’ Guidelines Recommending Screening for the Condition
Federal health officials and the American Diabetes Association issued new guidelines yesterday that recommend screening for "pre-diabetes" after finding that 16 million Americans between 40 and 74 years old have the newly defined "dangerous condition," which can lead to the "full-fledged" version of diabetes within a decade, the Wall Street Journal reports (Lueck, Wall Street Journal, 3/28). The guidelines are part of a new campaign to stem a "growing epidemic" of diabetes, which now affects an estimated 17 million Americans and costs the U.S. economy roughly $100 billion a year (Okie, Washington Post, 3/28). People with pre-diabetes have higher than normal blood sugar levels, but not high enough for a diabetes diagnosis. While pre-diabetes can lead to diabetes and increases the risk of developing heart disease by 50%, lifestyle changes such as moderate exercise and a more nutritious diet can delay or prevent the onset of full-blown diabetes if the condition is detected early, according to a recent study (Wall Street Journal, 3/28). "Diabetes has reached epidemic proportions and it's still on the rise," HHS Secretary Tommy Thompson said, adding, "What gives us hope ... is that people with pre-diabetes can take meaningful steps now to reduce their risks and avoid having diabetes" (Washington Post, 3/28).
The new guidelines aim to help inform the public and health professionals about pre-diabetes and offer ways to identify and treat the condition (Manning, USA Today, 3/28). The guidelines strongly recommend that people over age 44 who are overweight get tested for pre-diabetes. In addition, people who are younger than 45 and have at least one additional risk factor -- being overweight; having an immediate family member with diabetes; being a member of a minority group; having had diabetes during pregnancy or given birth to a baby weighing nine pounds or more; and having high blood pressure or cholesterol problems -- should be tested. According to the recommendations, two blood tests are available that measure a person's glucose level. If no pre-diabetes is found, the test should be repeated every three years. If a patient is diagnosed with pre-diabetes, counseling on weight loss and exercise should be provided, and the patient should be monitored every two years for diabetes (Washington Post, 3/28).
Even if the message about pre-diabetes gets through to the public, cost may be an issue in lowering diabetes rates. The screening procedures prescribed by the new recommendations, which cost about $25 each, are not covered by Medicare or Medicaid, according to officials. In addition, the minority populations that are most at risk of getting diabetes are also more likely to be uninsured. Thompson said he planned to "convince" insurers and employers to cover the screenings, saying they would help save money in the long run. "The truth of the matter 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," he said (Garvey, Los Angeles Times, 3/28).
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