Don't let the name "pre-diabetes" fool you. It is not just a precursor to a life-threatening disease. It is a serious medical condition that must be treated.

"The risk of heart attack and stroke triples to quadruples when you have the diagnosis of pre-diabetes," says Dr. Gary Trager, director of the Center for Diabetes and Endocrinology and Metabolism in Huntington.

Pre-diabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. The government estimates that more than 57 million Americans have pre-diabetes. The vast majority have not been diagnosed. The condition, which usually has no symptoms, is especially prevalent among adults older than 60. If the condition is left untreated, the majority of those with pre-diabetes will end up with type 2 diabetes.

If you are diagnosed with pre-diabetes, there is no magic bullet. "There is no pre-diabetes medicine on the market that is approved by the FDA," Trager says. "Diet and exercise are the cornerstones of treatment." Studies have shown that a low-fat, low-carbohydrate diet and moderate exercise can help stem the progression to diabetes and in some cases return pre-diabetics' blood sugar to normal levels.

But as Trager well knows, the problem is getting patients to follow the prescribed diet and exercise regimen. "They walk out all gung-ho, but the question is: How long are they going to do it?"

In fact, a new study found that many of those diagnosed with pre-diabetes ignore their doctor's orders. The study, published in the American Journal of Preventive Medicine, showed that about half those diagnosed with pre-diabetes did not try to lose weight, change their diet or increase the amount of exercise they do. "They're not convinced until they're told, 'You have diabetes,' " Trager says.

Trager says once the condition progresses to type 2 diabetes, it is much harder to control and the consequences often are deadly. ''Fifty percent of the people who have diabetes and have their first attack never make it alive to the emergency room," he says. "That's why we want to get them diagnosed early and treat them aggressively with diet and exercise - and make sure we keep on their backsides to do the best they possibly can."

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