You've probably heard about the large numbers of people in South Texas who suffer from diabetes. But what does it mean if you are diagnosed as pre-diabetes?
TPR's Bioscience Medicine reporter Wendy Rigby interviewed Curtis Triplitt, Pharm.D., a researcher at the Texas Diabetes Institute on San Antonio's West Side. This is a transcript of that interview:
Rigby: Prediabetes is sort of a new term to a lot of people. What does that mean?
Triplitt: Prediabetes means you’re at high risk for developing diabetes. It doesn’t mean that you have diabetes. Once you have diabetes, I don’t have anything for you to go back to being non-diabetic.
Rigby: What are some of the risk factors for developing this?
Triplitt: So we’re usually talking about people who have diabetes in their family already, any first degree relative. Someone who’s obese. Someone of color. You’ve had diabetes when you were pregnant. You might have hypertension. All these things are going to increase your risk of getting diabetes eventually.
Rigby: But if your doctor tells you ‘we’ve taken this test of your blood sugar. It’s higher than normal. You’re not diabetic yet but you’re on the way,’ is it a foregone conclusion?
Triplitt: Absolutely not. What he’s telling you is this is the time to act. The risk over about three to five years of getting diabetes is only about one in three of those people will get it. Over ten years there’s about one in two.
Rigby: Now the Centers for Disease Control says 86 million Americans prediabetes and that 90% don’t know it. What are the implications of that?
Triplitt: So we might have a tsunami of diabetes going on in the United States. The less people know the less they’re actually able to act on this risk. So saying someone has prediabetes helps them understand that they’re at high risk of something that they don’t want. Unfortunately once you have type two diabetes, we don’t have a cure and we don’t have a way to stop the cells in the pancreas from slowly degrading over time.
Rigby: So for prediabetics, exercise, controlling your weight and watching your diet. Are those the three most important lifestyle changes you can make to change your destiny?
Triplitt: I would absolutely say yes. So being active and activity can come in many forms. Of course, we want them not just watch their diet but actually decrease calories. That’s the most important thing. Everyone says ‘oh I’m at risk for diabetes because when I was young I ate too many sweets.’ That’s absolutely a myth. If you eat less calories and lose weight your risk of diabetes goes down.
Rigby: That’s sort of the unglamorous answer. People really don’t want to hear ‘diet and exercise. Diet and exercise.’
Triplitt: That’s absolutely right. And weight.
Rigby: And weight. Should people take a diagnosis of prediabetes seriously?
Triplitt: They should. Prediabetes is telling you I can intervene and prevent you from ever getting diabetes. It’s different when you have prediabetes versus treating diabetes.
Rigby: That brings up another question people have. Is there a pill I can take if I’m prediabetic so that I don’t become diabetic?
Triplitt: There are no current FDA approved diabetic medications that treat prediabetes. But there are a lot of medications out there that have proven benefit for decreasing your risk for going on to get diabetes. You have to talk to your doctor about that. But the most commonly prescribed one is probably Metformin.
Rigby: How big of a problem is prediabetes in our community?
Triplitt: Anything that’s national is going to be times two in San Antonio. So bottom line when you’re looking at risk of diabetes, you’re looking at prediabetes, it’s usually about one-and-a-half to two-fold worse in San Antonio. That has to do with our population. So we have a large Hispanic population in town. We just have a large, large number of people with diabetes.
Rigby: Bottom line, what would you like people to know about prediabetes that you think they don’t know?
Triplitt: Number one is that I see so much apathy towards prediabetes in our population. And understanding that this is not something that will happen to you eventually, it’s time now to think of it just like you would if you got high blood pressure or, God forbid, cancer. So you don’t just say ‘oh, I’ll take care of that next week or next year or in the next ten years.’ What you do is you say ‘I’m going to change some things now so that I don’t get the outcome I don’t want.’ So just intervene.
Rigby: Dr. Curtis Triplitt of Texas Diabetes Institute, thank you so much.
Triplitt: Thank you.
