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May-June 2012, Vol. XXVII, No. 3
 
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Your Health

'Pre-disease' diagnosis? Take steps now to lessen risks

Pre-diagnosis

Has your doctor diagnosed you with pre-diabetes, pre-hypertension, or osteopenia (pre-osteoporosis)? Be thankful for the early warning. You can take steps now to halt -- and maybe even reverse - these conditions.

Pre-diabetes
The pancreas makes the hormone insulin, which helps glucose move from the bloodstream into the cells, where it's used as fuel. When you have type 2 diabetes, the pancreas doesn't make enough insulin or your body doesn't use it effectively. So glucose accumulates in the blood. When you have pre-diabetes, blood tests indicate this buildup has begun.

A blood glucose level of 100 to 125 mg/dL using a fasting glucose test or a level of 140 to 199 mg/dL using a glucose tolerance test qualifies as pre-diabetes. Higher-than-normal blood glucose increases your risk of developing type 2 diabetes and cardiovascular disease, including heart disease and stroke. Complications of full-blown diabetes include cardiovascular disease, blindness, kidney failure and nerve damage.

To control pre-diabetes, lose excess weight by eating a healthy diet and exercising regularly. (Be sure to check with your doctor before beginning an exercise program.) If you're overweight or obese, trimming just 5 to 10 percent of your weight can significantly reduce your risk of moving from pre-diabetes to diabetes.

Pre-hypertension
Blood pressure measures the force exerted inside blood vessels when the heart beats (systolic pressure) and when it rests between beats (diastolic pressure). For most adults, having either a systolic pressure of 120 to 139 mmHg or a diastolic pressure of 80 to 89 mmHg qualifies as pre-hypertension. For those with diabetes or chronic kidney disease, the threshold is lower.

Pre-hypertension means you're at increased risk for developing hypertension, and higher pressure means greater risk. Hypertension can damage tissues throughout your body, particularly your heart, blood vessels and kidneys. To control pre-hypertension, eat healthy, exercise regularly and maintain a healthy weight. If you smoke, quit. Ask your doctor to help you devise a plan.

Osteopenia
Osteopenia means you have low bone density. It may be a precursor to osteoporosis, in which the bones become porous and brittle and fracture easily, especially at the hip, spine and wrist. About 10 million people in the U.S. already have osteoporosis, but 35 million people have osteopenia.

Doctors detect bone loss using bone mineral density tests, such as dual energy X-ray absorptiometry (DEXA). The results of DEXA yield a number called a T-score. A T-score of 1 to 2.5 is considered a case of osteopenia. Those with osteopenia are at increased risk for osteoporosis and thus bone fractures. Besides the short-term pain and inconvenience, fractures can lead to long-term disability and even death.

To control osteopenia, focus on good nutrition, get regular exercise and if you smoke, stop. If lifestyle changes aren't enough, your doctor may recommend calcium supplements or medicines to prevent or treat bone loss. Also, if you take medicines for another condition, ask your doctor if they might contribute to bone loss. Some can, including glucocorticoids (used for many diseases, including arthritis and asthma) and certain anti-seizure medications.

Healthy strategies
Eat a healthy diet. To combat pre-diseases, choose more whole grains, vegetables, fruits, low- or non-fat dairy products, beans, fish, skinless poultry, and low-fat, low-cholesterol, low-sodium foods. Eat less red meat, sweets, fried foods, baked goods, snack foods and foods with added sugar. If you drink alcohol, don't exceed one drink per day for women or two per day for men. If you have pre-hypertension, limit sodium intake by choosing low-salt and "no added salt" foods and seasonings.

For bone health, calcium-rich foods are particularly important. Choose low- or non-fat dairy products, dark green leafy vegetables, salmon and sardines with bones, soy-based foods and calcium-fortified foods, like some orange juice and cereal.

Exercise regularly. Engage in moderate, weight-bearing physical activity for at least 30 minutes a day to burn calories and stave off weight gain, improve your body's use of insulin, lower your blood pressure and strengthen your bones. Brisk walking, dancing, bowling, hiking, gardening and housecleaning all can do the trick. And remember, always check with your doctor before beginning any exercise program.

Being diagnosed with a pre-disease doesn't mean it's too late. On the contrary, it means you have a chance to make a real difference in your health.


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