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STEVE INSKEEP, host:

Okay. That's health care as seen by the pharmaceutical industry right now. Now let's talk about you.

It's time for Your Health, a regular feature here. And in Your Health today, beating back the risk of Type 2 diabetes.

NPR's Allison Aubrey reports on research that shows diet and exercise programs can be as effective as drugs in preventing diabetes among people who are otherwise likely to get it.

ALLISON AUBREY: Type 2 diabetes used to be thought of as a disease that only struck in old age. But physician John Buse says increasingly, the disease is hitting in the prime of life - and even younger.

Dr. JOHN BUSE (President-elect, Medicine and Science, American Diabetes Association): The idea of teenagers and people in their 20s developing Type 2 diabetes is really terrifying.

AUBREY: Buse is president-elect of Medicine and Science at the American Diabetes Association. He explains that people who have diabetes can develop a host of life-threatening problems because their bodies can't absorb sugars from the blood properly.

As the prevalence of the disease goes up, there are also an estimated 50 million Americans with pre-diabetes. These are people whose blood sugars have risen enough to put them at risk too. Most are overweight but don't yet have any symptoms or complications. To determine whether someone's become pre-diabetic, Buse says there's a simple test to measure fasting blood sugars.

Dr. BUSE: Well, I think until people have the screening test, I think a lot of them, you know, are sort of surprised that they're at risk.

AUBREY: Take, for example, Dianne Dunn. Ten years ago, when she was in her early 40s, she got screened - only because she happened to walk by a health fair that was being held near her office one day during lunch.

Ms. DIANNE DUNN (Data Analyst): It turned out to be life changing for me.

AUBREY: Dunn had diabetes in her family and she was overweight. So when she got the results of the screening test showing her blood sugars were in that pre-diabetic range, she knew she was on the road to developing some of the circulation and heart problems that her dad and aunt had gotten. At first, she felt powerless because back then she didn't think there was anything she can do, until she was introduced to a new diet and exercise plan.

MS. DUNN: Today I'm doing lower body. So I'm doing stuff for my legs for maybe seven or eight minutes to warm up the muscles.

AUBREY: We caught up at Dianne at her gym for a 7:00 a.m. workout.

MS. DUNN: I usually try to come two to three times a week.

AUBREY: And you always come this early?

MS. DUNN: Sometimes I'm here early at 5:30 so that I can get to work.

AUBREY: Dunn says she's not the same person she was a decade ago. Back then she was 40 pounds overweight. Her cholesterol was high, and she couldn't walk up her neighborhood hill.

MS. DUNN: I was a total couch potato. The first time I tried to walk up my block I was huffing and puffing like a person 80 years old.

AUBREY: Dunn has gotten a lot of help along the way. Her exercise and blood sugar has been closely monitored by researchers at Washington Hospital Center in the District of Columbia. Ten years ago the doctors set out to determine whether diet and exercise could be as effective as a diabetes prevention drug in staving off the progression of the disease.

At the time, physician Meeta Sharma and her colleagues were inclined to think that drugs would work better.

Dr. MEETA SHARMA (Physician): Our, you know, own kind of intrinsic appreciation of it was that just medical therapy is going to be the way to go in terms of prevention.

AUBREY: So researchers were quite surprised when they saw the success of Dianne Dunn and a hundreds of others in the study who'd been exercising for two and a half hours a week and dieting. After about three years, only five percent of them went on to develop diabetes, compared to 11 percent of the people who didn't exercise or diet.

It turned out that those in the study who took the medicine didn't fare as well as the exercisers. Washington Hospital Center's Meeta Sharma says eight percent of the people on the drug got diabetes.

Dr. SHARMA: And so when the study came out to show that there was such a huge difference that lifestyle made, it was a real eye-opener.

AUBREY: For Dianne Dunn, having her blood sugars back in the normal range means technically she's no longer pre-diabetic. And now that she's stronger and weighs less, she has more energy.

MS. DUNN: My endurance has definitely increased a whole lot, and I feel, I feel better for that.

AUBREY: But Dunn knows that she can't afford to slip off the exercise bandwagon. Her doctors have explained that she'll always be at risk of diabetes.

Dr. SHARMA: If she starts gaining weight, or now she becomes more sedentary and, you know, her exercise is not as vigorous as it was previously, then unfortunately, yes, she could develop it.

AUBREY: Dunn took care of her aunt before she died. She remembers all the diabetes complications - the vision problems, the exhaustion after dialysis.

MS. DUNN: This is very difficult. It's hard watching someone struggle.

AUBREY: Dunn says those images give her the will to stick with her healthy lifestyle, even if it does mean waking up at 5 A.M. to hit the gym.

Allison Aubrey, NPR News, Washington.

INSKEEP: The American Diabetes Association has an online test that estimates your risk of diabetes. And you can find a link to that test at npr.org/yourhealth. And that's Your Health for this Thursday morning.

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