June 12, 2006
Half of Americans risk diabetic condition
By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - Poor control of blood sugar may be a
much bigger health risk factor than most people realize,
experts told a meeting on Monday.
One study predicted that half of all Americans will develop
a condition known as insulin resistance, a type of pre-diabetes
that puts them at high risk of heart attacks, and another
showed that high blood sugar alone made hospital patients much
more likely to die of other conditions.
The studies, presented to a meeting of the American
Diabetes Association, show that early symptoms of diabetes and
heart disease must be treated aggressively, experts said.
These symptoms are often defined as the "metabolic
syndrome" -- an aggregate of risk factors such as obesity, high
cholesterol and other symptoms.
"If we could just detect and treat the metabolic syndrome
... we could reduce heart attacks in this country by 63
percent," said Dr. David Eddy of Archimedes Inc., a company
that makes computer-based analysis and decision-making tools.
Curing insulin resistance alone would reduce heart attacks
by 42 percent, Eddy told a news conference.
Normal blood glucose levels are 70 to 110 mg/dl, and
anything higher is often considered insulin resistance or
impaired fasting glucose.
Eddy's company is working on a computer program that would
help doctors predict which heart risk factors are the most
important for their individual patients.
Nearly 21 million Americans have diabetes, most of them
Type-2 diabetes. But the National Institutes of Health last
month estimated that a third of these people do not know it.
"We found that people with pre-diabetes clearly have an
excess of cardiovascular risk factors," Dr. Desmond Williams, a
diabetes expert at the U.S. Centers for Disease Control and
Prevention told the news conference.
His team examined interviews taken as part of an annual
national health survey. Of the 3,000 healthy adults aged 20 to
75, 28 percent had pre-diabetes, he said -- defined as having
fasting blood glucose levels of between 100 and 125 mg/dl.
Dr. Mercedes Falciglia of the University of Cincinnati
College of Medicine in Ohio found that non-diabetic patients
with high blood sugar who also suffered a heart attack, stroke
or chest pain were much more likely to die than other patients
with the same conditions.
Her team studied 216,000 severely ill patients admitted to
177 Veterans Affairs intensive care units.
Falciglia's team defined hyperglycemia as blood sugar
levels of 111 or higher. Hyperglycemia raised the risk of heart
attack death by up to five times and the risk of death from
stroke as much as 15-fold, she told the meeting.
"All patients should have their blood glucose levels
monitored when they are admitted to an intensive care unit
because hyperglycemia occurs in one-third of ICU patients,"
The CDC's Dr. Venkat Narayan and colleagues looked at a
person's lifetime risk of diabetes based on weight. "The
average lifetime risk for diabetes for a normal weight male
aged 18 years is 20 percent," Narayan said.
This increased to 57 percent for an obese male and 70
percent for a very obese male. The numbers are similar for
In the United states, more than 60 percent of the
population is overweight and 30 percent is obese.
The Diabetes Association's Dr. Robert Rizza said diet and
exercise is the place to start controlling this.
"But in the meantime don't tolerate high blood
(cholesterol), high blood glucose," Rizza said. He said drugs
should be used to control these in people who cannot or will
not lower them with diet and exercise.