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Publications and Products
Pre-diabetes in the United States in 2000
Source: Benjamin SM, Valdez R, Geiss LS, Rolka DB, Venkat Narayan KM.
Estimated number of adults with pre-diabetes in the United States in 2000: opportunities for
prevention. Diabetes Care 2003 March;26(3):645-9.
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Pre-diabetes is a new term for a condition that people get before they are diagnosed with diabetes. People who develop regular type 2 diabetes don't go directly from normal blood glucose (sugar) numbers to type 2 diabetes. Almost all go through a phase called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
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With IGT, the blood sugar level is elevated (between 140 and 199 milligrams per deciliter or mg/dL after a 2-hour oral glucose tolerance test), but is not high enough to be classified as diabetes. |
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With IFG, the fasting blood sugar level is elevated (between 110 and 125 mg/dL after an overnight fast), but is not high enough to be classified as diabetes. |
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Results from the Diabetes Prevention Program (DPP) indicated that adults at risk for developing type 2 diabetes could prevent or delay the disease with lifestyle changes in diet and exercise.
Based on the DPP results, the American Diabetes Association (ADA) recommended that all overweight people 45 years of age or older with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) should be classified as having pre-diabetes and that they are potential candidates for diabetes prevention interventions.
Overweight is defined as having a body mass index greater than or equal to 25 kg/m2.
To determine how many adults in the United States could potentially benefit from these interventions, researchers at the Centers for Disease Control and Prevention (CDC) estimated the number of adults with pre-diabetes.
 Results
- About one-fourth (22.6%) of overweight adults aged 45-74 years had pre-diabetes, which translates into about 12 million people in the United States in the year 2000.
- In the process of identifying people with pre-diabetes, we estimate that an additional 6.5 million people with undiagnosed diabetes would be detected.
- Among adults with pre-diabetes, the prevalence of cardiovascular (heart) disease risk factors was high:
- 94.9% had dyslipidemia (high blood cholesterol);
- 56.5% had hypertension (high blood pressure);
- 13.9% had microalbuminuria, a protein found in blood plasma and urine that can signal kidney disease; and
- 16.6% were current smokers.
Public Health Implications
- Our estimates suggest that several million adults at risk for developing type 2 diabetes may potentially benefit from diabetes prevention interventions.
- The immediate challenge is to translate research evidence for diabetes prevention into practice and policy.
- The following questions remain:
- Which groups of people may benefit the most from diabetes prevention interventions and by how much?
- How are we going to efficiently and effectively identify these groups of people?
- How are we going to deliver and sustain diabetes prevention interventions?
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