Jewish World Review April 1, 2002 / 20 Nisan, 5762

Pre-diabetes: a newly defined category of health risk

By Robert A. Wascher, M.D., F.A.C.S. | The Department of Health & Human Services, in conjunction with the American Diabetes Association, has initiated a new public information campaign to warn Americans about the health risks associated with a condition previously known as "impaired glucose tolerance."

This condition has now been anointed "pre-diabetes." Pre-diabetes is a precursor of overt diabetes, and occurs when the insulin receptors in the body's cells begin to lose their sensitivity to insulin. In healthy people, the pancreas secretes insulin after we eat a meal. Insulin then binds to insulin receptors on cells throughout the body, causing the cells to take in the sugar that has been absorbed into the bloodstream following a meal. In pre-diabetes, the cells begin to lose their sensitivity to insulin, allowing blood sugar levels to rise after meals containing sugars or carbohydrates (which are converted into sugars by the body).

Pre-diabetes is thought to affect about 16 million Americans, and has been linked to a 50% increase in the risk of developing coronary heart disease. Pre-diabetes also significantly increases the risk of developing diabetes, which results in dangerously elevated blood sugar levels without treatment. The majority of people with pre-diabetes will develop diabetes within 10 years, unless they take steps to reverse the factors that ultimately give rise to these two conditions: excessive calorie intake and inadequate physical activity (both of which can lead to obesity, which is also strongly linked to diabetes).

The new recommendations include the routine screening of overweight people over the age of 45 for pre-diabetes with one of several glucose tolerance tests. Patients who are younger than 45, but who are significantly obese, should also be screened if they have at least one of the following additional risk factors: a family history of diabetes, low blood HDL cholesterol levels, high blood triglyceride levels, high blood pressure, history of high blood sugar during pregnancy, and non-white ethnic group.

Even moderate exercise, such as walking for 30 minutes at a time, five days a week, can cut the risk of developing diabetes by more than half when combined with sensible dieting!


From the journal Science comes an intriguing-and worrisome-study that links even relatively modest television viewing among teens with an increased risk of aggressive or violent behavior during adulthood. A total of 707 teens and young adults were evaluated for their frequency of television viewing. Over a subsequent period of 17 years, incidents of aggressive or violent behavior towards others were also documented in this group.

Even after adjusting for tendencies towards aggressive behavior during childhood, childhood neglect, socioeconomic status, parents' educational level, level of neighborhood violence, and history of psychiatric disorders, the study's authors found a compelling link between television viewing habits and the onset of aggressive or violent behavior later in life.

Although this is not the first study to link television viewing with subsequent antisocial behavior, this study found that as little as 1 hour of TV viewing per day by teens and young adults was linked with a significantly increased risk of aggressive or violent behavior later in adulthood....


As we age, our bodies gradually lose muscle mass (unfortunately, our bodies also gain additional fat as well). There have been several previous studies that have shown improved levels of physical functioning in older men and women who engage in resistance strength training, including a reduced incidence of falls and bone fractures. This month's Archives of Internal Medicine features a new study that looks at the relationship between strength training and the capacity to become aerobically fit in elderly men and women.

A total of 62 volunteers, aged 60 to 83 years, engaged in 6 months of resistance strength training. These elderly weight-lifting volunteers were then tested on a treadmill to evaluate their aerobic exercise capabilities. The authors found that both low and high intensity weight training increased the aerobic exercise capabilities of these elderly volunteers by 20 to 26%! Older Americans wishing to begin a strength training and exercise program should find the results of this new study particularly interesting.

Remember, however, to check with your physician before beginning a new exercise program!


... The Archives of Internal Medicine also reports that while the prolonged consumption of coffee does seem to temporarily raise one's blood pressure, this habit appears to play a minimal role, if any, on the development of chronic high blood pressure.

The journal Lancet reports that the use of oral contraceptives for 10 or more years may be linked to an increased risk of cancer of the cervix. Almost all cases of cervical cancer are thought to be caused by a virus known as the human papilloma virus (HPV). It is not yet clear why oral contraceptives (OCs) should increase the risk of cervical cancer, although OCs are actually composed of synthetic female sex hormones. This finding is additive to previous studies showing an increased risk of cervical cancer in women with a history of multiple sex partners, and among women with 7 or more children. Fortunately, most cervical cancers can be detected early through annual Pap smears.

The journal Cancer Research reports that the common antibiotic doxycycline, a member of the tetracycline family, may have important anticancer activities. The drug appears to inhibit the growth of breast cancer cells in mice, and may reduce the ability of breast cancer cells to successfully spread to the bones (a common site of breast cancer metastasis). Further studies in humans will be necessary to confirm these findings, but it is nonetheless a very interesting finding.

JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at the John Wayne Cancer Institute in Santa Monica, CA. Comment by clicking here.


03/22/02: Bacteria, antibiotics & heart disease; mammograms: the debate continues; calcium & the risk of colon cancer ... and more
03/15/02: Mammography debate continues; statins & fracture risk; physical fitness & the risk of death; other intriguing findings
03/08/02: Blows to the chest & sudden cardiac death; air quality & the risk of lung cancer; tomatoes and your prostate
03/01/02: Diet & the risk of ovarian cancer; lifetime risk of developing high blood pressure; Osteoporosis prevention with a once-a-year injection?
02/26/02: The continuing controversy regarding screening mammography
02/22/02: Lowering body temperature after heart attack improves outcome; A silver lining for the chronically sleep-deprived?
02/15/02: Hormone replacement therapy & the risk of breast cancer; use it or lose it: Alzheimer's disease & cognitive stimulation; stress, divorce & death; child daycare, infections & parental guilt
02/08/02: Possible breakthrough in early cancer diagnosis; mammography: the controversy continues; CPR techniques revisited
02/01/02: Antibiotics in livestock feed & human disease; genetic detection of early colon cancer in the stool; genetic analysis of breast cancers may help decide treatment
01/25/02: Drug increases lifespan (if you're a fly...); workplace attitudes and smoking cessation; effects of inadequate sleep on surgeons
01/18/02: Lifelong effects of premature birth; smokers under the knife; aspirin and cardiovascular health
01/11/02: Estrogen levels in the blood & breast cancer risk; Heart attack: sex and survival; dangerous lettuce invaders
01/09/02: Cancer & aging: Two sides of the same coin?
01/04/02: Vitamin a & the risk of hip fracture in postmenopausal women; ovarian cancer risk and oral contraceptives
12/28/01: Magnetic Resonance Imaging (MRI) detects coronary artery disease; new development in obesity research; adverse childhood experiences & the risk of suicide attempts
12/21/01: Vaccination of children controls hepatitis a in the community; a possible cure for sickle cell disease; leptin and the risk of heart attacks
12/14/01: Chernobyl and the Risk of Thyroid Cancer in hildren; children & obesity; gastroesophageal reflux disease update
12/07/01: Update on school shootings; new implantable heart-assist device approved for further evaluation; prevention of fungal infections in pre-term babies
11/30/01: Flu vaccination in asthmatics; low-tar cigarettes are not less harmful; beans and your heart
11/21/01: Modified smallpox vaccine may reduce risk of cervical cancer; New approach to breast cancer diagnosis; New non-invasive prenatal diagnostic test for down's syndrome
11/16/01: Cholesterol-lowering drugs reduce risk of heart attack; supplemental radiation therapy reduces risk of breast cancer recurrence; brains of women may answer age-old questions
11/09/01: Bio-warfare (redux); my gray matter is bigger than yours; mad elk disease?
11/02/01: Making sense of bio-warfare
10/26/01: The impact of mammography on deaths due to breast cancer; diet & exercise may slow cancer cell growth; antidepressants and the risk of heart disease
10/19/01: New insights into autism; the wiley appendix
10/12/01: More bad news about obesity links to other diseases…Hey dad, can I borrow the car keys?
10/05/01: California leads nation in reduction of tobacco-related disease; exercise as an antidepressant?
09/25/01: Advances in the detection of breast cancer; primary care physician awareness of peripheral arterial disease; arsenic in the water
09/17/01: In perspective
09/12/01: Genes may hold secret to long life; men and women: cognitive function in the elderly; physical activity, obesity and the risk of pancreatic cancer
09/05/01: English milk cows prefer Beethoven and Simon & Garfunkel over Bananarama; new prostate cancer prevention study: looking for a few good men; exercise & diet can help prevent diabetes
08/28/01: Arthritis drugs may be linked with increased risk of heart disease; errors in blood clotting tests can be fatal; infant soy formula not associated with reproductive side effects

© 2002, Dr. Robert A. Wascher