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Understanding prediabetes

How to avoid diabetes and heart disease



No one needs to be schooled on the prevalence of heart disease, obesity and diabetes in America. While diabetes numbers are staggering – more than 29 million Americans (that’s 9.3 percent of the population) had diabetes in 2012 – it’s the number of people with prediabetes that is even more disturbing. In 2012, 86 million Americans over age 20 had prediabetes, according to the Centers for Disease Control and Prevention. That’s an 8.8 percent increase in two years, from 79 million in 2010.

An ‘early warning system’
Prediabetes is a condition in which the blood sugar level is higher than normal, but not high enough to be called diabetes. Also known as “impaired fasting glucose” or “impaired glucose tolerance,” prediabetes increases the risk of developing type 2 diabetes and cardiovascular disease.

“What concerns me most is that people are often unaware that they have prediabetes; it’s common for people to have prediabetes and show no symptoms at all,” said diabetes educator Cathy Thomas of Novant Health Diabetes Center at Novant Health Presbyterian Medical Center. “Without early diagnosis and education, people simply aren’t equipped to prevent it from developing into type 2 diabetes.”

The CDC and American Diabetes Association recommends those who are overweight and older than age 45 get tested for prediabetes. For those who are younger than 45 and overweight, testing is advised if you have certain risk factors, including high blood pressure, low high-density lipoprotein cholesterol and high triglycerides, family history of diabetes or previous gestational diabetes.

“It’s important to discuss your risk factors with your physician, and get tested for prediabetes if appropriate,” Thomas said. “Think of it as an early warning system – a simple test can alert you that you may need to make some lifestyle changes to avoid more serious conditions.”

Diagnosis and implications
Prediabetes is diagnosed through one of three different blood tests: the fasting plasma glucose test, which measures blood sugar levels after fasting eight hours; an oral glucose tolerance test, taken after drinking a sweet solution that challenges a body’s ability to process sugar; and the hemoglobin A1C, or average blood sugar test, which reflects average blood sugar over the past three to four months.

The tests help detect elevated sugar levels, which indicate prediabetes because the condition is closely linked to insulin, a hormone that causes cells in the body to store sugar. When a person’s body is insulin-resistant – as is true of many people with prediabetes – it takes much more insulin to move glucose from the bloodstream into cells. The pancreas makes more and more insulin in an attempt to keep the glucose levels normal, but in time, the pancreas may wear out and fail to keep up with the demand. Glucose levels then rise above normal.

“Insulin resistance leading to prediabetes and type 2 diabetes is part of a syndrome known as metabolic syndrome, which is also characterized by high blood pressure, excess body weight around the waist, high cholesterol and triglycerides,” Thomas said. “All of these are risk factors associated with other health concerns, such as cardiovascular disease.”

People with prediabetes have a one-and-a-half times greater risk of developing cardiovascular disease than people with normal glucose levels. Those who have diabetes have a two to four times greater risk of cardiovascular disease.

What you can do
“One of the biggest things to remember with this condition is that it does not automatically turn into type 2 diabetes or heart disease. Simple lifestyle changes, such as eating a little healthier or adding moderate exercise to the daily routine, can stop or even reverse the effects of prediabetes,” Thomas said.

One clinical research study recently showed that losing 5 to 7 percent of one’s body weight is effective in delaying diabetes. Those participants who lost weight and exercised reduced the progression to type 2 diabetes by 70 percent. They discovered that even minimal weight loss, such as five to 10 pounds, can make a huge difference.

Thomas recommended starting with small steps: having a leafy green salad before dinner, opting for water instead of soda or walking 30 minutes each workday.

“It will make you feel better! And it will help with your weight loss goals,” she said. “It’s small changes like these that can start improving people’s health and quality of life while also bringing down those alarming statistics.”

Take the test!
Think you could be at risk? Take the ADA’s diabetes risk test online here. It only takes 60 seconds and could save your life. Click here here to start.




Published: 10/10/2014