Diabetes is a silent, quiet killer. It is slow to develop and hard to detect because there are often no symptoms. If blood sugars are uncontrolled, diabetes can cause damage to the entire body – heart disease, stroke, kidney failure and blindness. It can lead to leg or foot amputations.

In recent years, doctors have started diagnosing “pre-diabetes” in people who have higher than normal blood sugar, but sugars not quite high enough to be called diabetes.

Pre-diabetes is also known as impaired glucose tolerance or impaired fasting glucose – a fancy way to say: your blood sugar is too high after eating, or too high when you wake in the morning.

The good news is that a diagnosis of pre-diabetes is like a warning light: Stop, take caution and evaluate your health now! About 11 percent of people with pre-diabetes will develop diabetes in three years. After the diagnosis of pre-diabetes, those who change their lifestyle – eating and exercise habits – can greatly reduce the risk of actually developing type 2 diabetes.

To understand pre-diabetes, you must understand diabetes. Diabetes occurs when a person’s body cannot use carbohydrate (sugar and starch) properly. The person’s blood-sugar levels rise too high. This excess sugar causes damage to the heart, nerves, eyes and kidneys.

Ninety percent of Americans with diabetes have type 2 diabetes, which runs in families. It is caused by having too little insulin production, along with insulin resistance.

A sedentary lifestyle and obesity lead to insulin resistance.

Type 1 diabetes afflicts the remaining 10 percent of Americans with diabetes. Type 1 diabetes is an auto-immune disease that causes destruction of the cells in the pancreas, where insulin is produced. Insulin is the hormone that allows blood sugar to enter body cells.

Not much can be done to prevent the onset of type 1 diabetes; however, type 2 diabetes – the most common kind – can often be prevented.

Pre-diabetes is a sign that you are on your way to developing type 2 diabetes. People used to call it “a touch of sugar” or “borderline diabetes.” Many times people did not take it seriously. Now we realize that pre-diabetes causes damage to the body.

If blood sugar levels are allowed to remain too high, too often, they can severely damage the body. It doesn’t matter whether the cause is type 1 diabetes or type 2 diabetes; the results are the same.

Being overweight can lead to insulin resistance, pre-diabetes and type 2 diabetes. Although there are some thin type 2 diabetics, they are the exception.

Type 2 diabetes used to be called Adult Onset Diabetes. As more and more children are becoming overweight and obese, they are developing this chronic, deadly disease.

About 25 percent of American children are overweight today. As the rate of obesity increases, the rate of diabetes increases.

The complications of diabetes will occur in more and more Americans at younger ages due to earlier onset. Our best tactic as a nation is to heed the warning of pre-diabetes.

Those who work with families with overweight children and adults find common threads. Most overweight children consume too many calories in soda, juices and other sugary liquids. They spend too much time sitting in front of a screen – TV, video games and computer. They don’t eat enough fruits and vegetables.

They don’t get regular physical activity. To add to the problem, overweight children often have overweight parents who are poor role models. Some think it must be genetic, if the parents are also overweight.

However, if you ask overweight parents about their lifestyles, often they, too, spend too much time in sedentary activities, get too little exercise and consume too many calories.

There have been many diet plans over the years to help people lose weight. Most are gimmicks that work only for the short-term. Staying at a healthy weight means sticking to a healthy eating plan your whole life. To lose weight, you must eat fewer calories than you burn.

You burn calories by exercising or getting physical activity. If you eat more calories than you burn, weight gain will occur. Fad diets often limit whole categories of food, which of course limits calories and causes weight loss. Yet, over the long haul, fad dieters will often go back to their old bad habits and not learn how to keep the weight off.

With the approval of their primary care provider, it is safe for overweight children to lose weight. Children as young as 2 years who already have complications related to their obesity – insulin resistance, pre-diabetes, high blood sugar, high cholesterol, high blood pressure, etc. – are encouraged to lose one pound per month.

Children 7 years and older who are overweight – without any complications from the obesity, yet – are encouraged to lose one pound per month. Overweight adults can safely lose 2 to 4 pounds monthly.

Teaching children and adults to eat healthier and be more active is a tricky business. The basics of weight loss are as easy as 5-2-1-0.

Eat five fruits and vegetables per day. Limit screen time with TV, video and computer to two hours or less. Get one hour of physical activity. Limit beverages to zero-calorie choices with the exception of 16 to 32 ounces – depending on the age of the child or adult – of fat-free or 1-percent milk.

However, children learn to eat like their parents. They learn to eat for comfort, to clean their plates and to eat their meals so they can be rewarded with dessert at the end. They learn to eat in front of the TV when they are bored, and to eat when angry or when celebrating a special event.

If you or your children are overweight, work on the above 5-2-1-0 steps to eating healthier and try to include as much activity in your lives as possible.

Try family outings that encourage activity. Go swimming, hiking, walking or bowling, and play active games such as kickball and tag. Do anything that makes you move your bodies more. Treating and preventing obesity is our key to preventing type 2 diabetes.

Lauri Jacobs is a certified diabetes educator and registered dietitian at EMMC.