Alec Baldwin Among 79 Million Pre-Diabetic Americans

A diagnosis of pre-diabetes last May gave award-winning actor Alec Baldwin the motivation to trim 30 pounds from a physique that, along with chiseled features, once earned him a place among People magazine's 50 Most Beautiful People.

A newly energized Baldwin, 53, revealed the health scare that lay behind his sleeker appearance during last Sunday's Screen Actors Guild Awards in Los Angeles, where he was named best actor in a comedy series for his work in the hit show "30 Rock."

Baldwin told "Entertainment Tonight" that he dropped the weight in just four months by giving up sugar and bumping up his activity with Pilates and spinning, but "not as much yoga as I'd like." 

No doubt he's gotten reinforcement from Hilaria Thomas, the 27-year-old yoga instructor and former competitive dancer he's been dating for almost a year.

"When we're shooting and I can't work out, I just have to eat less," he said. "So I'm very conscious of that. But sugar was the real killer for me. That was the problem."

Pre-diabetes places Baldwin among an estimated 79 million Americans with elevated blood sugar levels that can put them at risk of chronic, life-threatening Type 2 diabetes, according to the American Diabetes Association.  Diabetes specialists recognize pre-diabetes as a distinct entity, although "many, many primary care doctors don't recognize it or treat it" because the lifestyle interventions that can delay or prevent it are "hard to 'prescribe,'" said  Dr. Anne Peters, director of the clinical diabetes programs at the University of Southern California.

Peters, the author of "Conquering Diabetes," has devoted considerable time and research to aggressive prevention of diabetes and the accompanying ravages of heart disease, kidney failure, blindness and amputation. Weight loss is "very effective" at keeping pre-diabetes from progressing to Type 2 diabetes, she told Wednesday.

"Losing 7 percent to 10 percent of one's body weight with maintenance of that weight reduces the risk by half or even more," she said.

Baldwin, officially described on several entertainment websites as carrying 185 pounds on his six-foot frame, had gradually packed on the pounds since he was among the 1990 crop of Most Beautiful People.

Two years ago, despite being a Golden Globes nominee, he skipped the awards show to ski in Banff, Canada, reportedly complaining that he needed to lose 15 pounds, according to New York magazine.

This past weekend, he pranced around while mugging for cameras with his awards statue in hand, his jacket hanging loosely around his greatly reduced belly.

Belly fat is a particularly significant risk factor for diabetes and heart disease, as fat around the middle functions like an inflammatory organ. However, it's the first fat to go during weight loss.

With  Type 2 diabetes, the body cannot properly use insulin to break down sugar into energy for the muscles and brain. A combination of an underlying genetic predisposition and conditions such as obesity, lack of exercise, hypertension and high cholesterol drive its development.

However, the good news for those diagnosed with pre-diabetes is that diabetes isn't inevitable. 

If they simply do nothing to address it, "one-third will revert to normal, one third will stay stable and one-third will get worse," said Peters, a Los Angeles endocrinologist who specializes in diabetes prevention and treatment among adults and children from the low-income neighborhoods of East Los Angeles to high-income enclaves like Beverly Hills. "Maybe 15 percent of my patients in my Beverly Hills practice are being treated for it," she said.

The ADA identifies pre-diabetes based on results of two types of blood tests. One is a so-called fasting blood sugar reading of 100 to 125, measured after an overnight fast. At 126, a person is considered diabetic. The second measure is an A1C reading of 5.7 to 6.4, according to the ADA. At 6.5, a person is considered to have diabetes.

But there's considerable debate about those cutoffs within the diabetes community, said Peters, who said she and fellow diabetes specialists tend to view blood glucose levels "in a spectrum from normal [to] abnormal" without a "biological cut point that is 'diabetes' per se."

Peters finds rising readings particularly troublesome. 

"If someone is gradually getting worse with an A1C going up to 5.7 to 5.9 to 6.1, that is someone getting worse who needs attention," she said. "If someone just stays at 6.2, I am oddly less worried."

The A1C test measures glycated hemoglobin, a form of sugar that binds to the hemoglobin in red blood cells during the three-month life of those cells. The reading provides a three-month snapshot of how often blood sugar levels exceed a healthy range, reflecting how well, or poorly, someone is controlling their sugar consumption.

"I would say that everyone needs to know their numbers," for blood sugar as well as cholesterol and another type of blood fat called triglycerides, Peters said.

People with a family history of diabetes, with or without heart disease, should begin having fasting blood tests done at age 45 and learn what their numbers mean. If they're also overweight, they should begin having regular tests earlier, she suggested. 

"Often," Peters said, "doctors will dismiss a fasting sugar of, say, 103 but to me that is a sign of something potentially serious."