Pre-diabetes: a national health concern

Surprisingly, one in every three adults in the U.S. has a condition called “pre-diabetes.” That’s almost 100 million people! Astonishingly, nine out of 10 people with pre-diabetes are completely unaware that they have pre-diabetes. This is very alarming. 

What is diabetes?

Glucose is the main sugar in our diet that allows our cells and body to produce energy. When we eat, the glucose is absorbed into our blood. There is a protein, called insulin, that enables glucose to be taken up into our cells for energy production. Think of insulin like an usher at a theater directing patrons into the seats.

In diabetes, glucose is not taken up by the cells and remains in the blood. In the blood, glucose can be very damaging to the blood vessels, causing all kinds of health problems to the organs in the body supplied by the blood vessels. There are three main types of diabetes.

Diabetes type 1 is an autoimmune condition where the immune system destroys the cells in the pancreas that make insulin. As a result, there is no insulin, and outside insulin must be supplied. This condition can occur at any age, but it usually occurs in childhood.

Diabetes type 2 is not an autoimmune condition. Insulin is produced, but the body becomes resistant to insulin. This almost always is associated with being chronically overweight. Losing weight usually controls or cures diabetes type 2.

Gestational diabetes may be a temporary version of type 2 diabetes. This is associated with pregnancy and excessive weight gain. Often glucose levels return to normal after delivery, but not always.

There are other forms of diabetes including latent autoimmune diabetes in adults, maturity onset diabetes of the young, and neonatal diabetes mellitus. These will not be discussed in this article. This article will focus on pre-diabetes and diabetes type 2.


What is prediabetes?

Prediabetes is a condition where a person has significantly elevated levels of blood sugar. The levels of blood sugars are above normal, but they are not quite high enough to make the diagnosis of diabetes type 2. In most cases, if left unmodified or untreated, prediabetes will progress to diabetes type 2.

What are the long-term complications associated with diabetes type 2?

  • Heart disease
  • Increased risk of heart attack
  • Increased risk of stroke
  • Eye disease, vision changes, and even blindness
  • Nerve damage that can cause tingling and pain in hands and feet (called neuropathy)
  • Kidney disease
  • Recurrent infections
  • Gum and teeth diseases
  • Amputations due to recurrent infections, especially infections in the feet


How is prediabetes diagnosed?

The Centers for Disease Control offers a seven-question test. Take this test, and if you score five or higher, schedule an appointment with your doctor for a diabetes screening blood test. The seven-question pre-diabetes screening test and additional helpful information on pre-diabetes can be found at: www.cdc.gov/diabetesTV.


How is pre-diabetes treated?

The good news is that there are many steps that can be taken to prevent the development of diabetes type 2. These include:

  • Weight reduction to a desired target number, determined by your doctor
  • Eating healthy
  • Stress reduction

Additionally, the Centers for Disease Control has developed an excellent informational program on the prevention of diabetes type 2. It is called the National Diabetes Prevention Program. By participating and following the guidelines in the program, people with pre-diabetes can reduce the risk of developing diabetes type 2 by almost 60 percent!

Remember, most people with pre-diabetes don’t even know they have it. Take the screening test and talk to your doctor. Your good health and the good health of your family is in your hands.


  Find information on the National Diabetes Prevention Program at: www.cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He received his M.D. and Master’s Degree in Molecular Biology and Genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Dr. Crutchfield was recognized by Minnesota Medicine as one of the 100 Most Influential Healthcare Leaders in Minnesota. He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations.

Surprisingly, one in every three adults in the U.S. has…