By Dr. Steve Ponder

Diabetes has a lot of hard to understand terms associated with it. The term "prediabetes" was coined not that long ago. It was meant to simplify two older, more confusing terms that had been used by doctors for years: impaired fasting glucose and impaired glucose tolerance. The CDC says there are an estimated 57 million Americans with prediabetes. Fewer than one in 10 prediabetics are aware they have the condition.

Originally, prediabetes meant the person has a 5 to 10 percent chance of developing type 2 diabetes (not type 1) in the next five to 10 years. But recent studies suggest if nothing is done to change lifestyle (and ultimately weight), it's estimated two-thirds of prediabetics will become full-blown diabetics within six years. Only your doctor can tell if you have prediabetes and it requires a blood test or two. But you can get a good idea of your risk.

All you need is one of the following to justify getting screened each year for prediabetes: heart disease, family history of diabetes, non-white ancestry, being overweight or obese, a sedentary lifestyle, high blood pressure, high triglycerides in the blood, high LDL (bad) cholesterol, a history of gestational diabetes, delivering a baby over 9 pounds, polycystic ovary syndrome, bipolar disease and use of antipsychotic medicines for treatment of schizophrenia.

Everyone would love to have a pill or vaccine to prevent type 2 diabetes. Unfortunately, there are no FDA approved medicines to prevent type 2 diabetes in children or adults. There are many reports of improvement after weight loss surgery, even reversal of abnormal blood sugar levels in people with known diabetes, plus the ability to reduce or stop diabetes medications. Identifying people at risk and getting prediabetics into a lifestyle modification program has been shown to save more than $9,500 in yearly health expenses compared to people who don't get screened.

It's agreed treating prediabetes should be approached from two angles. First, intensive lifestyle modification (changing eating and physical activity habits) is invaluable. The second angle of treatment is using well-known methods and medications to treat high blood pressure and cholesterol.

A person with prediabetes should aim to lose 5 to 10 percent of their current body weight, plus increase their level of physical activity to at least 150 minutes per week of moderate activity, such as walking. Lose weight and you might lose the diabetes.

What we do know is it's useless for your doctor to simply tell you to diet and exercise five days a week and lose 20-30 pounds. As has been demonstrated to us on television shows like "The Biggest Loser," the secret to lowering weight and also the risk of developing diabetes is to join a program that sees you on a regular basis over time. But you must be willing to put out the effort and make the necessary changes in your lifestyle, which is really the hardest part. Ideally, it's best to get a lifestyle coach (if you can afford one) or join a fitness class at work or in the community. It's time and money well spent. Plus, what price tag do you place on your quality of life?

If we do nothing to change the rate Americans are developing diabetes, the current economic and health care crisis only will worsen over the next decade. This is not a partisan political matter, it's a quality of life issue. Perhaps only if our elected officials or their loved ones become touched by this disease will they put aside political differences and agree supporting diabetes and prediabetes education is the only way we will turn this problem around. Frankly, if we wait for a new medication or therapy to do this for us, just think what it would cost; and who would pay for it? In the end, prevention is far less costly and extends life as well.