Diabetes a serious risk for one-third of younger adults in Stanislaus County

A new study reveals that one third of younger adults in Stanislaus County have prediabetes, a condition that often leads to life-threatening Type 2 diabetes.

The study by the UCLA Center for Health Policy Research for the first time provides prediabetes rates by county in California, and it reinforces concerns about a growing diabetes epidemic.

About half of adults in the state have the prediabetes blood sugar readings that are the main predictor of diabetes, the study says. More than half of the state’s adult population, or 15.5 million people, have prediabetes, undiagnosed diabetes or have been diagnosed with the disease, the center says.

Up to 30 percent of those with prediabetes will become diabetic within five years if they don’t modify their lifestyles, and up to 70 percent will eventually struggle with diabetes, said Harold Goldstein, executive director of the California Center for Public Health Advocacy, which commissioned the research.

“We knew the diabetes epidemic was significant,” Goldstein said. “We did not know how much the epidemic is going to be growing in the future.”

Diabetes occurs when the body does not produce enough insulin to keep glucose levels from rising in the blood. The disease, affecting an estimated 2.5 million people in California, is a leading cause of blindness and kidney failure and is the seventh leading cause of death in the U.S.

Every week, about 125 California residents with diabetic complications lose a leg or part of a limb to amputation, Goldstein said.

The research estimates that 45 percent of adults in Stanislaus County have prediabetes, slightly lower than the statewide rate of 46 percent. San Joaquin County (39 percent) and Merced County (38 percent) have among the highest rates of prediabetes among young adults – age 18 to 39 – in the state.

The lowest estimated rates among young adults were 26 percent in Lake County and 28 percent in San Francisco.

To create a model for predicting prediabetes rates, the study used blood sample test results from the National Health and Nutrition Examination Survey. Researchers also relied on data from the California Health Interview Survey to come up with the estimates for counties.

People with a higher-than-normal blood glucose reading between 100 miligrams per deciliter and 125 mg/dl are considered to have prediabetes.

In a comparison of ethnic groups, 43 percent of Pacific Islanders had prediabetes, while the rate was 38 percent among African Americans, 36 percent among Latinos, 31 percent among Asians and 29 percent among whites.

Dr. John Walker, public health officer for Stanislaus County, said the study is valuable because it quantifies the health risk for a local population.

“We do have a big diabetes problem in California, as well as in our county,” Walker said.

Dr. Del Morris, medical director of the county Health Services Agency clinics, said it is “certainly a trend we should be alarmed about. It is not getting better. It is something that is going to build as our population ages.”

Many people with prediabetes are unaware of it. Insurers typically don’t cover the screening test for younger adults, said the study’s authors, who called for the state to promote more screening for prediabetes.

Dr. Ricky Bassi, an endocrinologist in Modesto, said adults in their 20s and 30s should pay close attention to lab results from their health providers. A rise in blood glucose levels or other unusual results should prompt a discussion with their doctors, she stressed.

Clinicians should watch for visible signs of prediabetes, such as heavyset body types or a velvety thickening of skin on the neck, Bassi said. The progression from prediabetes to Type 2 diabetes is fairly slow and can be prevented by dietary changes, weight loss and getting 150 minutes of exercise per week, she added.

Bassi said some patients with prediabetes are treated with Actos and Metformin, which are drugs that make the body more sensitive to insulin and lower blood sugars.

Morris said lifestyle changes, such as not drinking sugar-laden soda, are definitely part of diabetes prevention but habits are hard to change. The county health clinics screen patients for prediabetes if they have a family history of the disease, physical signs or other risk factors, he said.

“If they have prediabetes, we educate them on what that means and the fact that the earlier they address the problem, the less chance they have of developing complications,” Morris said. “Then we talk about diet and exercise. Some of them are put on medication.”

Goldstein said California is last among the 50 states in spending on diabetes prevention. At the same time, national diabetes rates have tripled over the past three decades and have increased 35 percent in California since 2001.

A 40-year-old diagnosed with diabetes will require $125,000 more in lifetime medical spending than a person who does not have diabetes.

“If diabetes rates double in the next five years, our health care system is going to be inundated,” Goldstein said.

This story was originally published March 10, 2016 at 4:00 PM with the headline "Diabetes a serious risk for one-third of younger adults in Stanislaus County."