The calm before the storm
Author: Sara Rider

For some of us it seems, the cards are stacked against us when it comes to our health. We may have a strong family history of a certain disease or condition, our ethnicity may make us more prone to certain health problems or our age may put us at higher risk.

When the health problem is type 2 diabetes, all of these things – family history, race and age – can increase our risk of developing a disease that affects some 25.8 million people in the United States. While many people might not be surprised to learn that a strong family history of type 2 diabetes increases their personal risk of developing the disease, many people do not understand that diabetes is a continuum, and the first step on this continuum is a condition called pre-diabetes. Knowing that you have pre-diabetes – and doing something about it – may prevent you from taking another step down the road to type 2 diabetes.

All in the family
“If you have a strong family history of type 2 diabetes, that kind-of sets you up for being at greater risk of developing diabetes, and developing it sooner than other folks,” cautions Dr. Stephen Pont, the medical director for the Texas Center for the Prevention and Treatment of Childhood Obesity. Other risk factors include an unhealthy weight, age, high blood pressure, high blood sugar and abnormal lipids.

“But if [you’re] genetically predisposed to some of these challenges, not every one of these factors has to be in place,” explains Julie Paff of the Seton Diabetes Education Center. “[You] may only have low HDL, or high blood pressure, or high blood sugar.”

When a combination of these factors occurs, doctors diagnose pre-diabetes. And according to Paff, people with pre-diabetes are “six times more likely to be diagnosed with diabetes in the future.”

Tipping the scale
For many people with pre-diabetes, the trigger is often a weight gain. The good news is that weight is one of the contributors that people can do something about, unlike a family history that may make them more inclined to develop some of the other risk factors.

“Most people who tell me they have been diagnosed with pre-diabetes have had a 10 to 15 pound weight gain,” says Paff. “That can sometimes be the beginning of pre-diabetes, because as we gain weight there are changes in our ability to process sugar.”

While blood sugar in pre-diabetes may not be so high that it causes the symptoms many of us associate with type 2 diabetes, people are still at higher risk of developing other health problems if they have pre-diabetes.

“Some 18 percent of people with pre-diabetes already have some early kidney disease,” reveals Paff, “and individuals with pre-diabetes are at twice the risk of getting heart disease.”

And while type 2 diabetes and pre-diabetes used to be only an adult problem, “due to childhood obesity, we’re seeing children with pre-diabetes and with type 2 diabetes,” Pont states. For children, the number one cause of pre-diabetes is excess weight.

Changing the course
Correcting the problem for both parents and children can begin by simply reversing an unhealthy weight.

“If you’re exercising and lose five to seven percent body weight and are able to sustain that weight loss, you can manage the symptoms of pre-diabetes and avoid future health problems,” adds Paff.

“If we get people to a normal weight, then they will get better,” says Pont. “The hard part is, how are we going to do that?” He says that weight loss for children or adults with pre-diabetes takes a combination of three things: making small changes over time, having the entire family make the changes together and staying positive.

“For some folks, making some of these changes can be quite difficult,” he concedes. “So we try to work with them to help them think about ways to make changes in their lifestyle to get to that healthier weight.”

Pont’s center gives the family “a menu of choices.” “People can say, ‘I think I can try turning off the TV while we eat dinner,’ or ‘I think I can try going for a walk as a family after dinner’ – making small changes rather than a crash diet.” He emphasizes that the family has to make changes together, “because these changes are healthy for everyone, and the kids are more successful if the parents are doing it as well.”

“The third part is to stay positive, because all changes are tough,” continues Pont. “We’re all going to have days where we’re not as healthy as we want to be, but we want to stay positive and say that tomorrow we’ll do a little bit better.” He continues, “If you’re challenged by your weight, you’re more likely to have some anxiety, some depression, some low self-esteem – so it’s important to have a positive, supportive family.”

For parents and children with pre-diabetes, the challenge of losing weight will vary from person to person.

“Some people can simply lose weight more quickly than others,” Pont suggests. “Some people need more small changes to lose weight. But eventually, if you add on those small changes, you will have success.”

And with successful weight loss, you can reverse a condition that can cause ongoing, serious health problems for both adults and children.

Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines.

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