You May Have Prediabetes and Not Even Know it!

Prediabetes could be called a silent epidemic. You won’t have any symptoms, yet your risk for heart disease and stoke increases by 50%. The American Diabetes Association reports that 79 million Americans have prediabetes.  And it is estimated that just 7 percent of people with prediabetes have been told they have it. Prediabetes is likely to turn into diabetes within your lifetime. The good news is that you can greatly reduce your risk of getting diabetes if you make the right lifestyle changes.  Read on to learn more about prediabetes, how to find out if you have it and what to do about it.

What is prediabetes?
It’s a condition where your blood sugar is higher than normal, but not high enough to be called diabetes.  In most cases it leads to diabetes.  I’ve been seeing many patients in my private practice lately who have been diagnosed with prediabetes (kudos for to their physicians for alerting them about it …years ago there was not as much of an awareness!)

Here is how I explain prediabetes to my clients…

When we eat carbohydrates, they break down into sugar in our blood. This happens with all carbs, including candy, juice, fruit, brown rice, potatoes, etc. In response to rising blood sugar levels, our pancreas secretes insulin in attempts to get the sugar out of the blood and into fat and muscle cells to be used as energy.  Think of insulin like a “key” trying to unlock the doors to the cells. Sometimes the key isn’t able to unlock the doors because the cells have become resistant to the insulin (called insulin resistance). So the pancreas has to work in overdrive mode and secrete large amounts of insulin.  So this large amount of insulin is able to keep blood sugar levels normal … for a while.  Eventually the pancreas starts to wear out from having to make so much insulin and your blood sugar starts to rise slightly. This is called prediabete and will eventually lead to full blown diabetes when your pancreas can no longer make adequate insulin to control blood sugar levels. The good news is that you can stop the progression of diabetes with lifestyle changes.

Top 12 risk factors for prediabetes
Being overweight (especially having excess fat in the abdominal area), inactivity, age (especially after age 45 … yikes!), family history, race (increased risk for African-Americans, Hispanics, American Indians,  Asian-Americans and Pacific Islanders), history of gestational diabetes, PCOS and inadequate sleep. Other conditions associated with diabetes/prediabetes are high blood pressure, high levels of triglycerides and low HDL “good cholesterol”. Please talk to your doctor about getting your blood sugar tested if you have any of these risk factors.

Diagnosing prediabetes
Check out the American Diabetes Association Risk Test. There are three different tests your doctor can order to test for prediabetes:    (pic: free-glucose-monitor.com)
– The A1C test  (Note: you do not have to be fasting to take this test)
Normal = less than 5.7%
Prediabetes  = between 5.7- 6.4%
Diabetes = 6.5% and higher

– The fasting plasma glucose test (FPG)  (Note: you do have to be fasting to take this test)
Normal = 99 mg/dl or less
Prediabetes = between 100-125
Diabetes = 126 mg/dl and higher

– The oral glucose tolerance test (OGTT)  (Note: you will need to drink a sugary drink given to you by your doctor to take this test)
Normal 139 mg/dl or less,
Prediabetes = between 140 mg/dl and 199
Diabetes 200 mg/dl and higher

Tips to prevent and treat prediabetes
The good news is that you can decrease your risk of getting full blown diabetes by making lifestyle changes. In addition, these changes can can improve health by lowering cholesterol and blood pressure.
1. Lose weight if you are overweight. Losing 5 to 7% of your weight (this is about 10 to 20 pounds if you weigh 200 pounds) can significantly decrease your blood sugar.

2. Get in at least of 150 minutes a week of physical exercise a week. A brisk 30 minute walk 5 times a week is a good start! (pic: lifestyleandchronicdiseases.wordpress.com)

3. Follow a healthy diet including lean protein, heart healthy fats, fruits, veggies, non fat or low fat dairy, legumes and whole grains. Focus on foods high in fiber and low in calories if you are trying to lose weight.

4. Having prediabetes doesn’t mean that you have to avoid all carbs! Many clients who come to my office with an initial diagnosis of prediabetes are somewhat “carb phobic”. While I agree that processed carbs (i.e. soda, candy, white bread) should be consumed in moderation (or when it comes to soda … maybe not at all!), whole grains and fruits should be included as part of a balanced diet. Of course, portion control is still a good idea!

November is National Diabetes Awareness month. Take the time to get tested for prediabetes … and encourage your loved ones to as well!

References:
Four ways to prevent and treat prediabetes
American Diabetes Association
Web MD