What Is Prediabetes?

What Is Prediabetes?

This sneaky health condition has no symptoms. But it’s almost always present before you get type 2 diabetes. It means your blood sugar level is higher than normal, but not yet high enough for you to be diagnosed with the disease. 

About 86 million people in the U.S. over age 20 have prediabetes. And doctors see the need to diagnose it more often. Treating it can prevent more serious health problems later on. These range from type 2 diabetes to problems with your heart, blood vessels, eyes, and kidneys

By the time you’re diagnosed with diabetes, many of these problems have already taken hold.

You’re most likely to get this disease if you:

 

 

You should get tested for prediabetes if you meet the criteria above and you:

 

Although most people with prediabetes have no symptoms, you might notice you’re extra thirsty, pee a lot more, or have blurred vision or extreme fatigue.

Your doctor can perform one of three different blood tests — the fasting plasma glucose test, the oral glucose tolerance test, or the hemoglobin A1c  test.

The fasting plasma glucose test measures your blood sugar after an 8-hour fast. If your blood sugar level is higher than normal after the test, you may have prediabetes.

The oral glucose tolerance test records your blood sugar after a fast and then again 2 hours after you have a very sweet drink. If your blood sugar is higher than normal 2 hours after the test, you may have prediabetes.

The hemoglobin A1c test looks at your average blood sugar for the past 2 to 3 months. It can be used to see if your diabetes is under control or to diagnose the disease.

Treatment for prediabetes is simple:

 

 

 

 

 

SOURCES: 

American Diabetes Association: “Standards of Medical Care in Diabetes — 2012.”

American Diabetes Association: “Pre-Diabetes.”

American Diabetes Association: “How to Tell if You Have Pre-Diabetes.”

National Diabetes Clearinghouse: “Insulin Resistance and Pre-Diabetes.”

Shoelson, S. Journal of Clinical Investigation, 2006.

Phillips, L. Diabetes Care, 2006.

Kim, S. Journal of the American College of Cardiology, 2006.

American Diabetes Association: “Diabetes Basics.”

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Prediabetes: 7 Steps to Take Now

Prediabetes: 7 Steps to Take Now

What to do to stop prediabetes from becoming diabetes.

Getting diagnosed with prediabetes is a serious wake-up call, but it doesn’t have to mean you will definitely get diabetes. There is still time to turn things around.

“It’s an opportunity to initiate lifestyle changes or treatments, and potentially retard progression to diabetes or even prevent diabetes,” says Gregg Gerety, MD, chief of endocrinology at St. Peter’s Hospital in Albany, N.Y.

Making these seven changes in your daily habits is a good way to start.

Becoming more active is one of the best things you can do to make diabetes less likely.

If it’s been a while since you exercised, start by building more activity into your routine by taking the stairs or doing some stretching during TV commercials, says Patti Geil, MS, RD, author of What Do I Eat Now?

Physical activity is an essential part of the treatment plan for prediabetes, because it lowers blood glucose levels and decreases body fat,” Geil says.

Ideally, you should exercise at least 30 minutes a day, five days a week. Let your doctor know about your exercise plans and ask if you have any limitations.

If you’re overweight, you might not have to lose as much as you think to make a difference.

In one study, people who had prediabetes and lost 5% to 7% of their body weight (just 10-14 pounds in someone who weights 200 pounds) cut their chances of getting diabetes by 58%.

See your doctor every three to six months, Gerety says.

If you’re doing well, you can get positive reinforcement from your doctor. If it’s not going so well, your doctor can help you get back on track.

“Patients like some tangible evidence of success or failure,” Gerety says.

Also, swap out high-calorie foods. “Drink skim milk rather than whole milk, diet soda rather than regular soda,” Geil says. “Choose lower-fat versions of cheese, yogurt, and salad dressings.”

Instead of snacking on high-fat, high-calorie chips and desserts, choose fresh fruit, or whole wheat crackers with peanut butter or low-fat cheese, Geil says.

Not getting enough sleep regularly makes losing weight harder, says Theresa Garnero, author of Your First Year With Diabetes.

A sleep shortfall also makes it harder for your body to use insulin effectively and may make type 2 diabetes more likely.

Set good sleep habits. Go to bed and wake up at the same time every day. Relax before you turn out the lights. Don’t watch TV or use your computer or smartphone when you’re trying to fall asleep. Avoid caffeine after lunch if you have trouble sleeping.

Losing weight, eating a healthy diet, and exercising regularly is easier if you have people helping you out, holding you accountable, and cheering you on, says Ronald T. Ackermann, MD, MPH, an associate professor of medicine at Indiana University School of Medicine.

Consider joining a group where you can pursue a healthier lifestyle in the company of others with similar goals.

A certified diabetes educator may also help you learn about what you need to do to prevent your prediabetes from becoming diabetes. You can find one through the American Association of Diabetes Educators.

Having the right mind-set can help.

Accept that you won’t do things perfectly every day, but pledge to do your best most of the time.

“Make a conscious choice to be consistent with everyday activities that are in the best interest of your health,” Garnero says. “Tell yourself, ‘I’m going to give it my best. I’m going to make small changes over time.’”

Those changes will add up.

SOURCES:

Ronald T. Ackermann, MD, MPH, associate professor of medicine, Indiana University School of Medicine.

Theresa Garnero, APRN, BC-ADM, MSN, CDE, author, Your First Year With Diabetes, American Diabetes Association.

Patti Geil, MS, RD, CDE, author, What Do I Eat Now?, American Diabetes Association.

Gregg Gerety, MD, chief of endocrinology, St. Peter’s Hospital, Albany, N.Y.

American Diabetes Association: “Prediabetes” and “Prediabetes FAQs.”

National Diabetes Information Clearinghouse: “Diabetes Prevention Program.”

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Type 2 Diabetes: The Basics

Type 2 Diabetes: The Basics

Diabetes is a life-long disease that affects the way your body handles glucose, a kind of sugar, in your blood.

Most people with the condition have type 2. There are about 27 million people in the U.S. with it. Another 86 million have prediabetes: Their blood glucose is not normal, but not high enough to be diabetes yet.

Your pancreas makes a hormone called insulin. It’s what lets your cells turn glucose from the food you eat into energy. People with type 2 diabetes make insulin, but their cells don’t use it as well as they should. Doctors call this insulin resistance.

At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can’t keep up, and the sugar builds up in your blood instead.

Usually a combination of things cause type 2 diabetes, including:

Genes. Scientists have found different bits of DNA that affect how your body makes insulin.

Extra weight. Being overweight or obese can cause insulin resistance, especially if you carry your extra pounds around the middle. Now type 2 diabetes affects kids and teens as well as adults, mainly because of childhood obesity.


Metabolic syndrome.
People with insulin resistance often have a group of conditions including high blood glucose, extra fat around the waist, high blood pressure, and high cholesterol and triglycerides.

Too much glucose from your liver. When your blood sugar is low, your liver makes and sends out glucose. After you eat, your blood sugar goes up, and usually the liver will slow down and store its glucose for later. But some people’s livers don’t. They keep cranking out sugar.

Bad communication between cells. Sometimes cells send the wrong signals or don’t pick up messages correctly. When these problems affect how your cells make and use insulin or glucose, a chain reaction can lead to diabetes.

Broken beta cells. If the cells that make the insulin send out the wrong amount of insulin at the wrong time, your blood sugar gets thrown off. High blood glucose can damage these cells, too.

While certain things make getting diabetes more likely, they won’t give you the disease. But the more that apply to you, the higher your chances of getting it are.

Some things you can’t control.

Some things are related to your health and medical history. Your doctor may be able to help.

Other risk factors have to do with your daily habits and lifestyle. These are the ones you can really do something about.

Because you can’t change what happened in the past, focus on what you can do now and going forward. Take medications and follow your doctor’s suggestions to be healthy. Simple changes at home can make a big difference, too.


Lose weight.
Dropping just 7% to 10% of your weight can cut your risk of type 2 diabetes in half.

Get active. Moving muscles use insulin. Thirty minutes of brisk walking a day will cut your risk by almost a third.

Eat right. Avoid highly processed carbs, sugary drinks, and trans and saturated fats. Limit red and processed meats.

Quit smoking. Work with your doctor to avoid gaining weight, so you don’t create one problem by solving another.

The symptoms of type 2 diabetes can be so mild you don’t notice them. In fact, about 8 million people who have it don’t know it.

Your doctor can test your blood for signs of diabetes. Usually doctors will test you on two different days to confirm the diagnosis. But if your blood glucose is very high or you have a lot of symptoms, one test may be all you need.

A1C: It’s like an average of your blood glucose over the past 2 or 3 months.

Fasting plasma glucose: This measures your blood sugar on an empty stomach. You won’t be able to eat or drink anything except water for 8 hours before the test.

Oral glucose tolerance test (OGTT): This checks your blood glucose before and 2 hours after you drink a sweet drink to see how your body handles the sugar.

Over time, high blood sugar can damage and cause problems with your:

The best way to avoid these complications is to manage your diabetes well.

 

SOURCES:  

American Diabetes Association: “Statistics About Diabetes,” “Type 1 Diabetes,” “Type 2,” “Diagnosing Diabetes and Learning About Prediabetes.”

U.S. National Library of Medicine: “Diabetes in Children and Teens.”

Cleveland Clinic: “Diabetes Learning Module,” “Preventing Diabetes Complications.”

National Diabetes Information Clearinghouse: “Causes of Diabetes.”

International Diabetes Federation: “Prevention,” “Complications of Diabetes.”

Harvard T.H. Chan School of Public Health: “Simple Steps to Preventing Diabetes.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Am I at risk for type 2 diabetes?”

Joslin Diabetes Center: “Common Questions About Type 2 Diabetes.”

Carolinas HealthCare System: “Yeast Infections and Diabetes: What You Should Know.”

Pagination

See how one patient learned to manage her weight and diet.

Are your ‘good’ habits doing harm?

How they help diabetes.

Are you at risk?

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Type 2 Diabetes: The Basics

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