Category: Diabetes 101

Better Choices, Better Health, the new online version of Stanford University’s Chronic Disease Self Management Program (CDSMP). This new program is free for people in seven pilot states, thanks to a grant from The Atlantic Philanthropies.

Better Choices, Better Health is a six-week, interactive workshop designed for people with a range of chronic health conditions, including diabetes. Participants learn new ways to manage their symptoms, reduce anxiety, and find community resources.

A little more info about Better Choices, Better Health:

Workshops can be accessed from any computer with an internet connection—including dial-up—making them accessible for those without access to transportation or broadband.

Led by trained facilitators, many of whom live with chronic conditions themselves, participants discuss:

• Dealing with anxiety and stress
• Managing pain and other symptoms
• Planning for the future
• Locating and using community resources
• Building communication skills
• Asking for help

The seven pilot states are: California, Hawaii, Iowa, Maine, Massachusetts, New Jersey, and Oregon. We hope to expand this list soon.

The National Council on Aging has licensed the program from Stanford University, but workshops are open to individuals of all ages.

Even more info: http://www.ncoa.org/improving-health/chronic-disease/better-choices-better-health.html

He sings, he dances and he can act. His name is Ben Vereen and he’s a diabetic. This star of stage and screen has taken his story to the people, and the people are listening.

Vereen struggled in his own past. He found out he was adopted in 1960 when applying for a passport to travel. His daughter died. He struggled with alcoholism. A car struck him. Had to learn to speak again after the accident, and more recently was diagnosed with Type 2 diabetes.

Today Vereen is in his 60’s, has a couple of movies and television movies that will debut soon and his one man show featuring music of Sammy Davis Jr. is a success. But according to DallasNews.com Vereen has a new message when it comes to diabetes, “Turn it around.”

Vereen also had a tough message for those who chose to consider themselves a victim of diabetes, “We need to stop seeing diabetes as a challenge or something that we suffer from, but rather it’s an opportunity to live a better life by taking better care of ourselves.”

To demonstrate his level of commitment to fighting diabetes Vereen has partnered with Sanofi-aventis to create an organization S.T.A.N.D. for Diabetes (Start Taking Action Now for Diabetes). The movement is self-described this way, “Whether you are an influencer in the world of entertainment, medicine, public health, or marketing, or someone living with or affected by diabetes in some way, we want you to look for opportunities in your daily activities to spread the message and become part of this movement. We challenge you to think differently about diabetes and imagine new ways to raise awareness about the disease and the importance of better blood sugar control NOW.”

Vereen is clear that it is his influence he plans on using to spread the news about diabetes, its causes, its struggles and ways to fight back. This is the call he makes to all of us – use whatever influence we have to reverse the trend of diabetes in our world.

According to a S.T.A.N.D. press release Vereen said, “When I was first diagnosed I did the things my doctor recommended — watching my diet, exercising more and taking my diabetes medication — but I wasn’t comfortable checking my blood sugar in public, but I’ve overcome my discomfort with the help of friends and family because I’ve learned that it’s so essential to control my blood sugar. Now checking my blood sugar is as comfortable as using my cell phone and my blood sugar is under control!”

Pointing to his optimistic nature Vereen refers to his condition as “lifeabetes.”

One of the key ways S.T.A.N.D. encourages others to influence is through social media like MySpace, Facebook and Twitter. These mediums are a preferred way for many to communicate making them an incredibly potent tool in spreading the news both personally and in wall posts or tweets.

The key reason this is suggested is because it’s easy for everyone to do. There is no need to speak publicly (unless you’re gifted to do so and want to). There is no need to lobby congress (unless you are determined to do so). This is effectively a 21st century attempt at a grassroots movement that spreads the news and invites people to action. People like Ben Vereen – people like you.

In August of 2007, the Medtronic Neuromedulation Company sent a letter to each of its customers. The top of the letter displayed this phrase: “Urgent Medical Device Correction, August 2007.” The letter disclosed some unsettling information about the SynchroMed EL infusion pumps.

The letter sent a clear warning to all those who had purchased a SynchroMed EL infusion pump prior to September of 1999. Mounting evidence had produced proof that pumps made before that date could stall at an unexpectedly high rate. The wear and tear on pumps made before September of 1999 could result in a sudden stoppage of delivery. Stalled pumps ceased delivery of insulin.

The letter emphasized the importance of its message. It indicated that the recall of the SynchroMed EL pump was a Class 1 recall. Any recall constitutes an action taken to address a problem with a product. The FDA can call for the recall of a medical device. A Class I recall underlines the harm that could result from continued and widespread use of a medical device with a particular problem.

The actual recall process had been initiated by the Medtronic Neuromedulation Company. As indicated, the Company had sent letters to each of the customers who had purchased a SynchroMed EL infusion pump. The Company had also completed another important step in the recall process.

When a company recalls a medical device, it needs to do more than just contact those who have previously purchased that device. It also needs to forewarn any customers who might now be thinking about buying that device. When a Company initiates the recall of a medical device, it must also put out a press release. In that release it must make clear what the name of the device that has been shown to be a potential threat to users of that device.

The Medtronic Neuromedulation Company had released such a statement to the press. It had also distributed information that could help customers to better identify the problem pump. Finally, the Company had acted to make the necessary changes in the pumps, changes that would eliminate any potential harm to a diabetes patient who was using that same pump.

The FDA led oversight of the actions taken by the Medtronic Neuromedulation Company. The FDA worked with Company officials to get out clear and complete information on the product that was being recalled. In addition, the FDA had asked the Company to issue a public statement, a statement outlining its recall strategy.

Once the Company had initiated its proposed recall strategy, then the FDA had conducted an audit of the Company. The FDA used that audit as a way to judge the effectiveness of the ongoing recall. The FDA also took steps to monitor the efforts being made to correct the device deficiencies, the deficiencies that had led to the recall.

Although the FDA has designed the recall process to limit the number of consumer concerns, the Agency realizes that some customers might still have questions. For that reason, it has announced several channels by which concerned customers, possibly diabetes patients, can direct their questions to those most apt to have the correct answer.

Diabetes patients who use or have used the SynchroMed EL infusion pump can obtain more information by calling 1-800-707-0923. They can also go online to this website: www.fda.gov/MedWatch/report.html. A diabetes patient who can not make a phone call or does not have access to a computer has yet another option. He or she can send a Fax to 1-800-FDA-0178.

Should a diabetes patient care to mail a letter to the executives at the company conducting the recall, then that patient should address that letter to:

Medtronic Neuromedulation Company
800 53rd Ave. N.E.
P.O. Box 1250
Minneapolis, Minnesota 55440-1250

It’s not often that you hear of medical science discussing diabetes and bones in the same sentence. Usually the heart and kidneys are the discussed in connection with diabetes, but new research suggests that the human bones may have a bearing on how the human body manages insulin.

MedPageToday indicates, “In the July 23 issue of Cell, [and] from two separate research teams [there is an indication] that insulin receptors in osteoblasts mediate release of the hormone osteocalcin, which speeds up glucose metabolism elsewhere in the body.”

MedicineNet.com defines osteoblasts as, “A cell that makes bone.” Meanwhile, “The hormone osteocalcin is secreted solely by osteoblasts (bone making cells) and thought to play a role in the body’s metabolic regulation and is pro-osteoblastic, or bone-building,” according to Wikipedia.

According to Gerard Karsenty, MD, PhD, of Columbia University in New York City, “The two studies suggest that drugs working through the osteocalcin pathway, if not the hormone itself, could be effective treatments for type 2 diabetes.

“Insulin signaling in osteoblasts [is] a critical link between bone remodeling and energy metabolism,” cited MedPageToday.com

The exciting part of this research is the fact that this provides a new link of potential in how the body works to correct health issues. As mentioned in the opening paragraph it is not often that anyone has spoken about diabetes and bone health in the same sentence.

The end result could be that individuals with diabetes may want to gain as much information about how the human bones can actually help regular blood sugar (glucose) as possible.

MedPageToday indicated these, “experiments also revealed what they called a “previously unappreciated” function of insulin in bone — that it boosts activity of an osteoblast regulatory molecule called Runx2, the end effect being that insulin helps promote osteoblast differentiation.”

The research on this finding was “funded by the Fond de la Recherche en Sante du Quebec, the National Institutes of Health, and the Juvenile Diabetes Research Foundation.”

The long and short of the research suggests that it is possible the bone making cells interact in a more significant way with diabetes by infusing the hormone osteocalcin into the body. This hormone is helpful in regulating diabetes. The hormone appears to act in concert with the bone-making cells to create an atmosphere that is equipped to help with the in-body care needed to thrive with diabetes.

According to MedPageToday both research groups suggested, “In total, the findings demonstrate the delicate and interactive nature of the processes underlying bone formation and resorption.”

The research may further indicate what possible ways this knowledge can be used to accelerate the body’s ability to accept a more efficient flow of information and successful implementation and absorption of insulin within the body, and used by bone making cells.

The body is a very complex organism that is often discovered to be more complex than we ever realized. DNA is an example of the complexity, but even within that undeniably unique set of body blue prints we continue to learn more and more about not only the various parts of our internal structure, but also how those parts interact in ways we never imagined.

These latest studies remain a prime example of how that plays out in scientific data and potential medical fixes for those occasions when two parts of the body that normally work well together are in the midst of a struggle.

If you’ve ever watched a survival type show on television then you know there are extremes in food availability that people endure and they seem to come out of these issues safely. There is a chromosome protein that acts as a rescue device and the discovery of how it functions may have a huge impact on how diabetes is treated.

According to Medical News Today, “Researchers at McGill University and University of Pennsylvania have uncovered new insights into how a protein known as the AMP-activated protein kinase, or AMPK, a master regulator of metabolism, controls how our cells generate energy.”

Imagine if you will, a drill sergeant in the Army. He commissions soldiers to go from one place to the next to fulfill the needs of the overall operation. He’s in charge of many soldiers and each is told what to do and when to do it. This is a picture of what AMPK is like in the human body.

If the AMPK determines the body’s resources are not required for energy then it will not willingly allocated energy resources without just cause.

McGill Professor Russell Jones is quoted in Medical News Today as saying, “”The discovery that AMPK goes directly to the DNA to affect gene transcription is a breakthrough in our understanding how signals from outside the cell are transmitted to change gene expression. It is like an electrical circuit. We have figured out how AMPK mediates the connection.”

If you’re wondering why this is big news the answer lies in what medical science can potentially do with this information. They may be able to effectively send new orders to the AMPK allowing the use of energy cells to be used in metabolism – even during times when the AMPK would not normally do so.

As a society we’ve encountered an alteration in our overall lifestyle. Where once we were more active in physical labor today we are much more sedentary so our bodies are not used to the idea of needing to burn added fat or energy cells.

Medical News Today helps explain the process. “AMPK’s main role is to sense cell stress. In this study, cells were stressed with ultraviolet radiation and low levels of glucose, a common source of cell energy. In the sequence of events after stress, AMPK picks up the cell-stress signal and travels to the nucleus to bind to the tumor suppressor gene p53. This in turn, causes a phosphate to be added to a histone near the p21 gene, which activates transcription. The function of the p21 protein is to stop or slow down the cell cycle.”

If medical science can simulate cell stress then it may be possible to induce a more effective use of glucose and a fat burning metabolism as it works to encourage AMPK to regulate a change that gains benefit from an effective use of blood glucose.

Medical News Today reports, “The work conducted by the researchers holds promise for new therapies for a number of diseases including diabetes and cancer. For example, AMPK is a target of metformin, the most commonly prescribed drug for the treatment of Type II diabetes. By understanding how AMPK can directly change gene expression, this may lead to the identification of new disease-associated targets and potential therapies.”

In the end this is one more potential therapy that may result in improved care for those who live with diabetes.

What would happen if medical science could put a tight reign on blood glucose levels? Would it have a significant impact on those living with diabetes? If so, how would it help? A five-year study provides some interesting insight.

According to Voice of America (VOA), “The government-funded study is called ACCORD, which stands for Action to Control Cardiovascular Risk in Diabetes. The study included high-risk diabetes patients – typically older and obese, with a history of complications.”

Conventional medical wisdom has been that tight control of blood glucose is helpful in all phases of diabetic self-management. However the findings pointed in a different direction, “Some patients got medicine to aggressively reduce cholesterol or blood pressure or their blood sugar levels. They were compared with patients in a control group who got standard treatments.

“None of the aggressive treatments significantly reduced the risk of heart attacks, strokes, or other cardiovascular complications,” reported the VOA.

Voice of America cited ACCORD researcher William Cushman who said, “Our composite cardiovascular outcome of dying from cardiovascular events or having a non-fatal heart attack or a non-fatal stroke, that combined outcome was not significantly reduced.”

We have reported similar finding in the past, but this research did uncover a benefit that perhaps they had not anticipated from tight blood glucose control. The VOA report stated, “One positive outcome from the ACCORD study was evidence supporting ways to improve what doctors call diabetes patients’ microvascular conditions. The disease affects small blood vessels in a way that can damage nerves, kidneys and the eyes. So, Emily Chew of the National Eye Institute noted that aggressive lowering of blood sugar or cholesterol levels helped control the progression of eye disease.”

Since one of the major long-term symptoms of diabetes is blindness and retinopathy this is actually very significant. In many cases diabetics must undergo eye surgery to save their vision as diabetes progresses. This new information suggests it is possible to either delay or perhaps even stop the advance of retinopathy and blindness in diabetics through effective blood glucose control.

As we reported earlier the VOA report confirms yet again, “In another part of the ACCORD study, patients got intensive therapy to lower their blood sugar. After three and a half years, the group getting intensive therapy was switched into the control group, to standard therapy, because they were dying at a higher rate.”

Some researchers suggest that the study should be expanded to see what results might be seen in younger patients who live with diabetes. Perhaps, it is theorized, there can be positive results from very tight control when a patient is younger. The treatment could then be altered as they age.

What most are concluding from the new information found in recent editions of The Lancet and The New England Journal of Medicine is that tight blood glucose control may be problematic for those who are known to have cardiovascular issues. The same is true for those who have diagnosed kidney disease.

As medical science continues to explore the causes and control of diabetes more becomes known about the treatment of the disease. While this information is counter to general thought it can and should result in better long-term care for diabetic patients.

As with all of life working toward a better balance of control and outcome is the best-case scenario for diabetes.

Recently the U.S. Government Subcommittee on Health convened to discuss the overall progress on diabetes in the United States. What follows are highlights from that subcommittee meeting.

Ann Albright, PhD, RD
Director, Division of Diabetes Translation

“Several research studies… have demonstrated that a structured lifestyle program, which results in a modest weight loss of 5 to 7 percent while encouraging a healthy diet and increasing physical activity, can reduce risk for type 2 diabetes by 58 percent in those at high risk for diabetes or who have pre-diabetes. Based on the findings of the Diabetes Prevention Program clinical trial and subsequent NIH-supported studies that have translated these research findings into real world settings, CDC and our partners are implementing the National Diabetes Prevention Program. This program focuses on delivering the proven intervention in-group settings for a cost of about $250 to $300 per person per year. The National Diabetes Prevention Program takes a four-pronged approach: training the workforce, a recognition program for quality assurance, funding sites to deliver the intervention, and health marketing to increase the program’s utilization.”

Judith E. Fradkin, M.D.
Director, Division of Diabetes, Endocrinology, and Metabolic Diseases

“One approach to combat the diabetes epidemic in the U.S. is to prevent the disease. The Diabetes Prevention Program (DPP) clinical trial showed that people with pre-diabetes-defined as having blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes–can dramatically reduce their risk of developing type 2 diabetes through lifestyle changes that achieve modest weight loss or through treatment with the drug metformin, although the metformin intervention was much less effective than the lifestyle intervention. The interventions worked in all ethnic and racial groups studied, in both men and women, and in women with a history of gestational diabetes. Research now shows that, after a 10-year period of following DPP participants, the interventions result in long-term benefits: people still had a lower risk of developing type 2 diabetes and those who made lifestyle changes also had reduced cardiovascular risk despite taking fewer drugs to control their heart disease risk factors?”

Robert A. Goldstein, M.D. PH.D.
Senior Vice President, Scientific Affairs for the Juvenile Diabetes Research Foundation International

Promising research include(s):

• Vaccine to Prevent Type 1 Diabetes Onset: Research toward the development of a vaccine to reverse the immune attack that causes diabetes holds great promise for type 1 diabetes patients. NIH- and JDRF-funded researchers have successfully cured and prevented type 1 diabetes in mice using a vaccine made of nanoparticles thousands of times smaller than the size of a cell, coated with proteins involved in immune cell communication. Thanks to NIH funds from the Special Diabetes Program, researchers have shown that these particles are safe for use in humans.

“The NIH, JDRF and privately-funded researchers are also working on promising vaccine therapies to preserve beta cell function in people newly diagnosed with type 1 diabetes.”

If you read articles on this site you know there are plenty of promising research statistics along with new discoveries that are providing hope and answers to diabetics. This subcommittee hearing was designed to bring top minds together to point out new avenues in which diabetic research can go and applaud those things that have been successful in facilitating change in the way we deal with the disease.

There will always be something to work on, but as demonstrated above there are also hurdles that have already been crossed.

How much effort would you put into spreading the message about diabetes and its impact on you and those who love you? For one New Jersey resident the answer is running more than 3,000 miles in about 3 months. Learn more about Yijoo Kwon.

Kwon immigrated to the United States from South Korea. In fact, the New York Times indicated Kwon was a soldier for South Korea during the Vietnam War.

Diagnosed in 1996 as a Type 2 diabetic, Kwon was overweight and under challenged. He was a successful business owner, but diabetes presented it’s own difficulties. One diagnosis proved Kwon to be a fighter to be admired.

Kwon took up running and dropped his weight by about 60 pounds. Running became something of an obsession for Kwon who has participated in more than 100 marathons. However, no race to date held more personal interest than a recent trip from Los Angeles to New York.

The purpose of this trip was to raise awareness to the disease that is Type 2 diabetes. Kwon ran through rain, cold and heat averaging around 30 miles per day. For Kwon there were no days off.

Kwon made stops in large and small towns from Riverside, California to Meade, Kansas. Kwon discovered areas both largely urban and ultra rural. Resting each night in an RV. His wife provided the leg massages he needed to endure another long day on the road.

Often Kwon’s days started by 4 AM and he stopped running by 2 PM. This helped him avoid the hottest portion of any particular day. By the time the personal race was finished he held a news conference at the United Nations to talk about his trek and the need to be vigilant about diabetes.

Christopher McDougall is a fellow marathon enthusiast who followed Kwon’s journey with interest and even planned on joining him for a portion of the run. McDougall posted on his blog June 2nd, 2010, “Catch him while you can. Just check out his numbers: May 26, 34.01 miles; May 27, 34.01 miles; May 28, 34.04 miles…

Unreal.

“Yijoo Kwon, the 64-year-old diabetic who began beating his disease the day he began running, is still blazing across the U.S. on his solo transcontinental run. He expected to be back home in Queens by July 9, but he’s moving so fast, he’ll almost certainly be early. He’s in Ohio right now, but at an average pace of 34 miles a day, he won’t be for long.”

Kwon’s own website bears witness to the transformation that led to such an endurance runner, “At the age of 51, Mr. Kwon was diagnosed with type 2 diabetes and was given an effective death sentence by doctors. The disease was an inevitable consequence from his unhealthy diet and sedentary lifestyle, and his future looked bleak. Mr. Kwon did not give up, however. He began walking, and little by little worked up to jogging and finally running. With sheer determination in the face of a potentially terminal illness, Mr. Kwon was able to fight his diabetes and claim back his life through running. These days, he runs several marathons a year and fully controls his diabetes through exercise and a healthy diet, without medication.”

While forgoing medication is not advocated in most instances Kwon was resolute in his determination to wage a lifelong war with the disease.

Kwon has indicated an interest in writing a book about his cross-country journey and how his own diabetes provided the motivation for the trek.

In the same way asthmatics use rescue inhalers to reduce bronchial issues a new product may allow similar assistance for the symptoms of diabetes.

According to WebMD, Inhaled insulin proved to be as effective at lowering blood sugar levels as standard insulin injection treatment, and with minimal side effects, among patients with uncontrolled type 2 diabetes.

“Reporting in this week’s American Diabetes Association meeting and in The Lancet, researchers compared two approaches to managing type 2 diabetes among patients ages 18 to 80 from 10 different countries. The patients were nonsmokers and had poor control of blood sugar despite insulin therapy.”

There were just over 200 participants in this experimental distribution method while a slightly higher number of patients in the control group received standard diabetic treatment. At the end of the one-year study there were several findings that may be of interest to those living with diabetes.

• Blood sugar levels were similar in the two groups; 22% of patients in the inhaled insulin/insulin glargine group reached a goal A1c level of 7% or less while 27% of those solely on insulin injections reached the goal.
• Patients using the inhaler gained less weight — a major concern among diabetes patients. The inhaler group gained only an average of about 2 pounds, whereas the control group gained an average of about 5.5 pounds.
• Patients using the inhaler had fewer episodes of hypoglycemia — a sudden drop in blood sugar — than those in the comparison group, occurring in 31% of patients on inhaled insulin/insulin glargine group vs. 49% of those in the insulin injection group.
• Patients using the inhaler reported more side effects with coughing and upper respiratory infections. Most of the coughing occurred within the first 10 minutes of inhalation and primarily during the first week of treatment and declined as treatment continued.
• Prior use of metformin, an oral drug commonly taken to manage blood sugar, did not affect results among the two groups of patients. (Source: WebMD)

Of particular interest is the fact that blood sugar was controlled more tightly when the inhaled insulin was used. Weight gain was less problematic with the inhaled insulin and hypoglycemia incidence was reduced.

On the other hand there were the side effects that caused some patients initial problems although it was noted those symptoms subsided following regular use.

WebMD quotes researcher Julio Rosenstock, MD as saying “Our findings show that inhaled insulin plus insulin glargine, alone or in combination with an oral antidiabetes drug such as metformin, is an effective alternative to conventional insulin therapy (biaspart insulin) in uncontrolled type 2 diabetes.”

In an effort to provide full disclosure WebMD further reported, “This research was funded by MannKind Corp., a California-based bio-pharmaceutical company that manufactures Technosphere, the inhaler device used to deliver the insulin in this study. MannKind is using Technosphere to administer an inhaled insulin drug called Afreszza, which has not yet been approved by the FDA.”

The primary voice of caution in this case has to do with the side effects of respiratory discomfort. Some in the field of medical science are concerned about the effects of this new distribution method on miniature air sacs in the lungs known as alveoli.

It’s a safe bet that more tests will follow to help determine if the findings can be replicated and to learn more about the potential side effects and how they may ultimately influence those who may choose to use this product should it become available.

The Centers for Disease Control (CDC) suggests that a better understanding of what prediabetes is could help prevent the expansion of diabetes. Knowing what leads to diabetes can be a powerful tool of disease avoidance.

The following information was provided by the CDC to help identify issues related to prediabetes.

Prediabetes: Impaired glucose tolerance and impaired fasting glucose

Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes. People with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke.

• People with prediabetes have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Some people have both IFG and IGT.
• IFG is a condition in which the fasting blood sugar level is 100 to 125 milligrams per deciliter (mg/dL) after an overnight fast. This level is higher than normal but not high enough to be classified as diabetes.
• IGT is a condition in which the blood sugar level is 140 to 199 mg/dL after a 2-hour oral glucose tolerance test. This level is higher than normal but not high enough to be classified as diabetes.
• In 1988–1994, among U.S. adults aged 40–74 years, 33.8% had IFG, 15.4% had IGT, and 40.1% had prediabetes (IGT or IFG or both). More recent data for IFG, but not IGT, are available and are presented below.

Prevalence of impaired fasting glucose in people younger than 20 years of age, United States

• In 1999–2000, 7.0% of U.S. adolescents aged 12–19 years had IFG.

Prevalence of impaired fasting glucose in people aged 20 years or older, United States, 2007

• In 2003–2006, 25.9% of U.S. adults aged 20 years or older had IFG (35.4% of adults aged 60 years or older). Applying this percentage to the entire U.S. population in 2007 yields an estimated 57 million American adults aged 20 years or older with IFG, suggesting that at least 57 million American adults had prediabetes in 2007.
• After adjusting for population age and sex differences, IFG prevalence among U.S. adults aged 20 years or older in 2003–2006 was 21.1% for non-Hispanic blacks, 25.1% for non-Hispanic whites, and 26.1% for Mexican Americans.

Prevention or delay of diabetes

• Progression to diabetes among those with prediabetes is not inevitable. Studies have shown that people with prediabetes who lose weight and increase their physical activity can prevent or delay diabetes and return their blood glucose levels to normal.
• The Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, showed that lifestyle intervention reduced developing diabetes by 58% during a 3-year period. The reduction was even greater, 71%, among adults aged 60 years or older.
• Interventions to prevent or delay type 2 diabetes in individuals with prediabetes can be feasible and cost-effective. Research has found that lifestyle interventions are more cost-effective than medications.

The best news in this prediabetic information is that type 2 diabetes can be prevented through certain lifestyle adjustments. These adjustments can lead to a longer life and a significantly better quality of life.

This information is important as the number of undiagnosed diabetes continues to rise. Because a diabetic can have the disease the not know it until the disease is well entrenched it is important to know what signs to look for as an indicator of what you may need to do to avoid the disease.