See also: The CDC is trying to make 86 million Americans sick

The CDC is correct in calling attention to a health condition, pre-diabetes, afflicting 86 million Americans.  Laudably, they have publicized lifestyle programs in community centers, pharmacies, faith-based organizations, and online to reverse this condition.

Pre-diabetes is officially defined by the American Diabetic Association as having an elevated A1c level of 5.7 or more, but less than 6.5, the level at which diabetes is diagnosed.  A1c measures blood sugar over the past two or three months.  The goalposts for diagnosis have shifted; not long ago, you needed to have a level of 6.0 to be called pre-diabetic and 7.0 to be diabetic.

Diabetes can be prevented and in many instances reversed by proper nutrition and exercise.

The prevention of diabetes is extremely important as a public health measure.  In the U.S., we will be spending billions of dollars on diabetes care in coming decades.  There is increasing recognition that diabetes and Alzheimer’s disease are inextricably related.  In fact, the concept that Alzheimer’s is Type 3 diabetes has been around for a decade.

Type 1 diabetes develops from childhood, and Type 2 is adult onset (although many children are now getting Type 2 diabetes). The cost of Alzheimer’s in the U.S. in 2015 was $226 billion.  There are new initiatives for reversing Alzheimer’s, mainly with lifestyle modification.  Blood sugar control is a central aspect of these programs.  In the Bredesen protocol, which reversed 6 out of 7 cases of early Alzheimer’s in a pilot program, the AIC goal was 5.3, much stricter than the current prediabetes marker.

In fact, even before blood sugar problems are detectable, there can be dysfunction in the beta cells of the pancreas, causing insulin resistance.  Before diabetes with actual insulin deficiency develops, high insulin levels can occur due to lack of sensitivity to insulin.

Insulin resistance is the major cause of obesity.  The epidemic of obesity, with a large percentage of the U.S. youth unfit for military service, has profound implications for our combat readiness and national security.  Obesity is also a big factor in the poor U.S. ranking in maternal mortality statistics.  Insulin resistance can damage the brain even before blood sugar rises and is a contributing factor to cancer, cardiovascular disorders, and hormonal infertility.

Mark Hyman, M.D. has coined the term “diabesity” for the current epidemic of obesity, pre-diabetes, insulin resistance, and Type 2 diabetes.  His excellent book, The Blood Sugar Solution, is dedicated to “the first generation of children in history that will live sicker and die younger than their parents.”  Desire to live in a free society is paramount, but some regulation might be necessary if common sense prevails.  One place to start is removing government incentives for high-fructose corn syrup and other junk foods.

Blood sugar control, insulin resistance, and obesity are linked to our well-being as a nation.  Americans may never accept waist measurements in the workplace as part of a national program to curb obesity, as do the Japanese.  But a lifestyle education program as proposed by the CDC is a modest first step.

Mary L. Davenport, M.D., M.S., FACOG practices obstetrics and gynecology and integrative medicine in El Sobrante, California.