They have prediabetes, a condition where blood sugar is higher than normal but not high enough to be classified as type 2 diabetes. A special diabetes report in the November issue of Mayo Clinic Women's HealthSource covers prediabetes and what can be done to prevent it from becoming type 2 diabetes, a potentially debilitating and life-threatening disease.

Overlooking prediabetes is easy, because often there are no symptoms. And blood tests for prediabetes aren't given routinely.

People age 45 and older who have never been tested for diabetes should discuss prediabetes screening with a physician. A blood glucose test will likely be recommended for people who have any of these risk factors:

A family history of diabetes A body mass index of 25 or higher Low levels of high-density lipoprotein (HDL or good) cholesterol and high triglycerides, another blood fat High blood pressure A history of gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds Polycystic ovary syndrome An ethnicity that is disproportionately affected by diabetes, including African-American, American Indian, Hispanic-American/Latino and Asian-American/Pacific Islander.

For those who have prediabetes, making healthy lifestyle changes can significantly reduce the risk of developing diabetes. One large research study found that diet and exercise that resulted in a 5 percent to 7 percent weight loss could lower the risk of diabetes in high-risk individuals by 58 percent. For example, someone who weighs 200 pounds could potentially prevent diabetes by losing just 10 to 15 pounds.

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Kim and Karnik suspected menin might be the link other researchers had been looking for. To test that idea, they gave prolactin to nonpregnant mice. As predicted, menin levels dropped and the pancreas increased in size, mimicking what is seen during pregnancy.

Kim said that although most of this research relates to menin regulation during pregnancy, similar forces may be at work in obese adults with diabetes. He and Karnik found that obese mice have less menin in the pancreas than mice at a normal weight. That finding suggests that menin may have a central role in obesity-related diabetes as well.

Kim said prolactin may be just one way of regulating menin levels and as a result regulating pancreatic growth. Other hormones may be involved in increasing or decreasing menin in nonpregnant adults.

Understanding the mechanisms of regulating menin should lead to new ways of growing islets for transplantation into people with type-1 diabetes and could lead to new treatments for diabetes in pregnant women or obese adults, Kim said.

Gestational diabetes, which is on the rise nationwide, is becoming more recognized as a significant risk to mothers and their babies. Sen. Hillary Rodham Clinton, D-NY, recently cosponsored a bill aimed at devoting more funding to understanding, preventing and treating the disease.

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