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Prediabetes serves as loud wakeup call

Dr. Jane Sadler Tribune News Service

I exercise, stay slim and think I am reasonably careful about my diet. Subtract the dark-chocolate habit and minus the Cheetos cravings, I make fairly good choices. So I was shocked to learn that my fasting blood sugars were bordering on high and my numbers were leaning toward becoming prediabetic. How could this be?

Prediabetes results from a combination of poor lifestyle choices and hereditary predisposition. The Centers for Disease Control and Prevention estimates that 86 million people, or 1 in 3 adults, in the United States have prediabetes.

Mildly elevated blood-sugar levels such as mine should be a knock on the door for lifestyle changes, for more reasons than you may realize.

Besides the commonly known diabetes-related heart and vascular complications, there are more reasons to pay attention to your medical provider’s advice when it comes to elevated blood sugars. As reported in May’s Diabetologia, prediabetes may increase the risk of developing cancer by as much as 15 percent.

If your blood sugars continue to escalate and you develop diabetes, your risk for all cancer types increases up to 41 percent compared with nondiabetics, according to a 2008 study in the Journal of the American Medical Association.

In addition, a 2011 New England Journal of Medicine article reported that middle-aged men with diabetes died about six years younger than their nondiabetic counterparts.

Those researchers found associated increased risk for premature death from both heart and non-heart-related factors, including several cancers. Diabetics were found to have higher risks for cancers of the liver, pancreas, ovaries, colon, lungs, bladder and breasts.

In the past, researchers have linked obesity, lowered immunity and inflammatory factors as causal reasons for increased cancer risks and cancer mortality in diabetics. More recently, a study from Molecular Cell 2013 found elevated sugars triggered increased activity of a protein, beta-catenin. Accumulation of this protein is a known factor in the development of many cancers.

There is good news for prediabetics and diabetics. According to Cancer Prevention Research 2012, a commonly prescribed diabetes medication, Metformin, demonstrated a 31 percent reduction in cancer compared with other blood-sugar-lowering drugs. In 2013, the Cleveland Clinic published research with similar outcomes using another type of diabetes drug, thiazolidinedione. Several study trials are examining the use of Metformin and healthy lifestyle changes as a complement to chemotherapy for many conditions including colorectal, uterine and lung cancer.

One of the best ways to decrease your risk of cancer is to live a healthy lifestyle and avoid diabetes and heart disease. The American Cancer Society reports that up to one-third of cancer deaths are related to poor diet and low activity.

According to the CDC, without weight loss and regular exercise, 15-30 percent of people with prediabetes will become diabetic over the next five years, and of those who develop diabetes, 1 in 4 will not know they have the disease.

My father did not know it; not until he suffered a debilitating stroke was his advanced diabetes diagnosis made clear. Annual blood-sugar testing should be part of a routine office medical evaluation.

Due to my hereditary diabetes risk, perhaps it is time to rethink my dark-chocolate and Cheetos vices. While it is not necessary to completely eliminate my favorite comfort foods, they should be eaten in moderation and only on special occasions. Now, if I could only get the makers of Cheetos to dip them in dark chocolate. I would have one food choice to limit instead of two.

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