Sam Bauman: When it’s not serious but not to be ignored



I have a friend in his early 80s who is happy, healthy, does some exercise and dines mostly in restaurants; no homemade meals for him.

He has told me several times that his doctor has said he is verging on diabetes but that it is not yet serious. I was thinking of his situation when I read in the Consumer Reports publication On Health about something called “pre-disease.”

What it means is that you don’t have an illness but that you are inching toward one. With pre-diabetes, for instance, it means that you don’t have the disease but that you’re close to it. Your blood sugar levels are higher than normal but not high enough for diagnosis as type 2 diabetes. There are other “pres” pre-glaucoma, pre-osteoporosis, pre-hypertension.

In some cases you may need further tests or medications. But making changes in diet and physical activity may be enough.

“We sound; not turn otherwise healthy people into patients, and most pre-disease can be treated with simple lifestyle changes,” says H. Gilbert Welch, M.D., and author of “Less Medicine, More Health.”

Remember that some conditions are a natural part of aging, like wrinkles or losing hair. And sometimes doctors overreact and order unneeded tests.

Here’s some advice for common “pre” conditions.

Pre-hypertension is suffered by about 37 percent of Americans, for blood pressures between 120 and 139 systolic (upper reading) and 80 to 89 diastolic (lower reading. You’re more likely hypertense if you’re overweight or smoke. A study showed that those with hypertension had a higher risk of cardiovascular disease. Before working on hypertension make sure you’re in the “pre” range.

Have your blood pressure checked two or three times 30 minutes after coffee or exercise, you’ve emptied your bladder and you’ve been sitting quietly for five minutes in a chair, not on the exam table. You probably won’t need medication for pre-hypertension. More than half patients have been treated with medications but there’s no convincing evidence that it helps. You can cut the increases in hypertension with lifestyle changes.

“Take a good look at what you’re eating and get off the couch,” says Dr. Niece Goldberg. Losing up to nine pounds can lower systolic pressure for hyper-tense people by about 4.5 points.

The American Heart Association recommends at least 40 minutes of moderate exercise three or four times a week, using less than 1,500 mg of salt a day, limiting alcohol to no more than two drinks a day for men, one for women, and a diet of fruits, vegetables, whole grains, low fat dairy, beans, skinless poultry and lean meat and fish.

I’ve suffered from “pre” diabetes for more than a decade and I followed the standard progress. First, no “pre” back in those days. My doctor just said “You’re diabetic” and prescribed some pills. That lasted until Dr.Yamamoto here shifted me to personal insulin injection, where I’ve been ever since. Doesn’t interfere with skiing and I do pay attention to diet and regular daily exercise. And three of my sisters suffered from the disease. Today pre-diabetes shows up in a test of blood sugar over the months that indicates a hemoglobin or 5.7 to 6.4. About 38 percent of Americans suffer from pre-diabetes. You’re more at risk if you’re 45 or older, overweight, sedentary, have a family history of the disease or you developed gestational diabetes during pregnancy. Up to 30 percent of those with pre-diabetes develop type 2 diabetes within five years if they don’t make lifestyle changes. Progressing to type 2 puts patients at higher risk of heart attack or stroke, and nerve, kidney, eye and foot damage, and may contribute to Alzheimer’s disease. You don’t need drugs to treat pre-diabetes. Prevent progression by losing 5 to 10 percent of body weight (7 to 15 pounds for a 150-pound woman and 9 to 18 pounds for an 180-pound male) says Marvin M.Lipman, M.D., Consumer Reports medical adviser.

People with “pre” who lost about 7 percent of their body weight by eating less fat, fewer calories and exercising for about 150 minutes a week had a 58 percent of reduced risk of type 2 diabetes.

You’ll also want to focus on foods low on the glycemic index, such as nonstarchy vegetables. A check for diabetes once a year works or more if your doctor suggests it. We’ll go into pre-osteoporosis and pre-glaucoma next week. Meanwhile, a P.S. about my super new hearing aids, thanks to Dr. Weeks. Lately, I’ve occasionally been hearing a faint rumble. Finally figured out it was my refrigerator at work.

Sam Bauman writes about senior issues for the Nevada Appeal. Check out his blog at


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