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Your Health

Prevent prediabetes and metabolic syndrome

You could be on the fast track to diabetes and don’t even know it. Prediabetes and the related metabolic syndrome may not cause any noticeable symptoms, but they do put you on the path to Type 2 diabetes and its complications: heart attacks and strokes, nerve damage, vision loss, kidney failure and more.

Chances are good that you or someone you know has one or all of these conditions. The Centers for Disease Control and Prevention estimate that as many as 80 million American adults have impaired glucose (blood sugar) control that signals prediabetes. Almost as many more have metabolic syndrome, a group of conditions that are harbingers of diabetes. These diseases are often silent and go untreated until the symptoms of actual diabetes appear.

The digestive system turns carbohydrates into blood glucose. As this glucose rises, the pancreas releases insulin, which allows glucose to move out of the blood stream into the muscle cells and be burned, along with oxygen, to produce energy. When insulin resistance develops, the system is impaired, ultimately leading to Type 2 diabetes.

If your fasting blood glucose is 100 to 125 mg/dl, chances are you’ve got prediabetes. Metabolic syndrome, not a disease in itself, is a constellation of conditions, usually related to obesity. If you’ve got any three of these – a waist larger than 35 inches for women or 39 inches for men, blood pressure higher than 129/84, high blood sugar or insulin resistance, high triglycerides or low good cholesterol (HDL under 50) – you’ve got metabolic syndrome. Insulin resistance means that your body does not use the hormone insulin as effectively as it should, especially in the muscles and liver.

The good news is that both prediabetes and metabolic syndrome can be stopped in their tracks with simple lifestyle changes, most notably diet, weight-loss and exercise. You are not doomed to become diabetic. Explore the resources at Stanford Health Library to learn more about these conditions and ways to control their effects.

A good place to start is the ever-popular “Dummies” series. “Prediabetes for Dummies” (Wiley, 2009) by Alan L. Rubin, M.D., is a great primer for people who want to learn about the condition and how to beat it. It is a highly palatable book, written in plain English. It tackles a serious topic in a light, friendly way. Loaded with valuable information for patients of all ages, the book explains causes and treatment of prediabetes and offers suggestions for diet and exercise.

The book includes a week-by-week plan to help readers become healthier in three months and an excellent chapter on metabolic syndrome and its relationship to prediabetes.

No “Dummies” book would be complete without a section of “Tens,” summarizing the book’s main points in easy-to-follow lists. These include “Ten Myths about Prediabetes,” “Ten Staples to Keep in Your Kitchen” and “Ten Things to Teach Your Prediabetic Child.”

Another excellent resource focused on diet in prediabetes is available as an electronic book from the Stanford Health Library website. “Eat What You Love, Love What You Eat with Diabetes: A Mindful Eating Program for Thriving with Prediabetes or Diabetes” (New Harbinger, 2012) by Michelle May, M.D., can be found online at healthlibrary.stanford.edu/resources/ebooks.html. Follow the instructions for entering the user name and password, then search for the title or enter “prediabetes” in the search box.

The seminal work on the metabolic syndrome is “Syndrome X, The Silent Killer: The New Heart Disease Risk” (Simon & Schuster, 2000) by Stanford University’s Gerald Reaven, M.D. “Syndrome X” is another term for metabolic syndrome. Although the book was published 13 years ago, it remains a classic and offers helpful information supported by excellent documentation.

A new book at Stanford Health Library, “Metabolic Syndrome and Cardiovascular Disease” (Wiley-Blackwell, 2012) by authors T. Barry Levine and Arlene Bradley Levine focuses on metabolic syndrome and its relationship to heart disease. Written for clinicians, the authors carefully explain the pathophysiology of metabolic syndrome and offer rationale for effective interventions. There is an interesting discussion on the importance of sleep, in addition to the roles caloric restriction and bariatric surgery play in controlling the syndrome.

There are many more resources at Stanford Health Library, where research assistance and information packets are available free of charge. For more information, visit healthlibrary.stanford.edu/resources/bodysystems/endocrine_diabetes.html#pre.

Stanford Health Library is now located in Hoover Pavilion, 211 Quarry Road, Suite 201. The library is free and open to the public 9 a.m. to 5 p.m. daily. Access is also available on the third floor of Stanford Hospital and on the main level of Stanford’s Cancer Center.

Nancy Dickenson is head librarian at Stanford Health Library. For more information, call 725-8400, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit healthlibrary.stanford.edu.

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