Samuel Johnson once remarked, “Nothing sharpens the wit so much as the knowledge you’re going to be hanged in the morning.” So if a doctor says, “Your blood sugar is borderline for diabetes” or “Your bones are getting fragile”, he’s giving you a pre-disease warning. But does it ring the bell of trouble ahead unless you do something about it?
Dr. H. Gilbert Welch, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, is also the author of Less Medicine, More Health.
Welch says we should keep in mind that, “Virtually everyone, as they get older, develops some sort of pre-disease.”
The outward appearance of wrinkles and graying hair are for all to see. But kidneys, hearts and all the other hidden organs also age. So Welch warns there’s a tendency for doctors to over-prescribe pre-diseases that can be corrected by other means.
According to a report in Consumer Reports on Health, about 37% of adults in North America have pre-hypertension. Studies show that if you’re overweight, smoke, drink too much alcohol, rarely exercise and have a family history of hypertension, you’re more likely to develop borderline BP and finally hypertension.
So what should you do about it? First, make sure you have bone-fide increased BP.
Some people on medication show ‘white coat hypertension’ due simply to being in a doctor’s office, or having just consumed caffeine. To prevent a lifetime of medication, test your BP in a pharmacy, or buy a blood pressure cuff to take readings at home.
Today, there is no convincing evidence that treating pre-hypertension by drugs prevents the development of high blood pressure. But studies show that dropping nine pounds will lower blood pressure 4.5 points.
Health authorities also stress that it’s important to exercise moderately three to four times a week. It also helps to consume no more than 1,500 milligrams of sodium daily, a little more than half a teaspoon, and to limit alcoholic drinks to two a day for men, and one for women. And to follow a diet rich in fruits, vegetables, whole grains, low fat dairy products, fish, skinless poultry and lean meats.
Pre-diabetes is now a major problem and affects 38% of North Americans. It’s present when the average blood sugar over a period of three months, or a fasting blood sugar, is higher than normal.
One would think that this diagnosis would get people’s attention. But according to the Centers for Disease Control and Prevention, up to 30% don’t make lifestyle changes and eventually develop Type 2 diabetes.
This is a huge mistake.
Calorie reduction and exercise can decrease the risk of Type 2 diabetes by 59% over a three-year period. Reversing this trend also means a decreased risk of heart attack, stroke, kidney failure, blindness, foot damage and possibly Alzheimer’s Disease.
Let’s end with some good news.
It’s estimated that in North America 45 million people have osteoporosis. But, according to a study in the New England Journal of Medicine, most of the time osteopenia is best treated with diet high in calcium along with 800 IU of Vitamin D, and weight-bearing exercise such as walking. Authorities say the evidence that osteoporosis drugs help during this stage is inconsistent.
Dr. Marvin Lipman, medical advisor on Consumer Reports, states that about 30% of older adults are reported to be suffering from advanced chronic kidney disease and have received needless drug treatment. In effect, doctors should realize that kidneys age, but it’s a slow process, and not to over-treat.
Others over 65 are often taking thyroid medication to treat an underactive thyroid. But unless there are symptoms such as dry skin, fatigue, severe constipation and weight gain they may not need it.
Knowing you have a pre-disease is a great benefit. It provides time to get serious about one’s health and prevent a full-blown disease with all its complications. Prevention will always be better than cure, particularly when it’s possible to treat pre-disease by lifestyle changes.
Isn’t this better than facing a lifetime on prescription drugs?
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