Prediabetes / Prevention

Prediabetes

Before people develop type 2 diabetes, they almost always have "prediabetes"—blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. Type 2 diabetes is a progressive condition, and a person’s glucose could have been elevated for years by the time he or she is diagnosed. In fact, according to the Centers for Disease Control, 86 million Americans—more than one out of three—have prediabetes.

Unfortunately, 9 out of 10 people with prediabetes don’t even know they have it, according to the Centers for Disease Control and Prevention (CDC). This is especially unfortunate because without lifestyle changes, 15 percent to 30 percent of people with prediabetes will develop type 2 diabetes within five years.What’s more, prediabetes correlates with an increased risk of developing cardiovascular disease, the leading cause of death in the U.S.

Taught by our team of experts, our Diabetes Prevention Program can help you learn what steps you can take to prevent prediabetes from developing into type 2 diabetes. Take our Diabetes Risk Assessment to find out if you are at risk!

Getting Tested

These tests are used to determine whether a person has prediabetes:

  • Fasting Blood Glucose Test
    The fasting blood glucose test measures blood glucose after a period of fasting, usually in the morning. If the glucose is between 100 and 125, the diagnosis is impaired fasting glucose (IFG), or prediabetes.
  • Oral Glucose Tolerance Test (OGT)
    The oral glucose tolerance (OGT) test measures the blood glucose level during fasting and again two hours after the ingestion of a glucose drink. If the fasting blood glucose is in the normal range but the glucose level is high after the sugary drink, the diagnosis is impaired glucose tolerance (IGT), or prediabetes.
  • A1C Test
    The A1C test is first used to diagnose both prediabetes and type 1 and type 2 diabetes. Once a person has been diagnosed, their doctor will periodically prescribe an A1C test to determine how well they are managing their diabetes. This blood test provides information about a person’s average blood glucose levels over the three months just prior to testing. An A1C test result is reported as a percentage: a normal A1C level is below 5.7 percent. Anything above that number is an indication that blood glucose has been elevated over time: 5.7­–6.4 is considered to be prediabetes; 6.5 and above indicates diabetes.

Prediabetes by the Numbers

The numbers below are indicative of prediabetes:

  • An A1C of 5.7–6.4 percent
  • Fasting blood glucose of 100–125 mg/dl
  • An oral glucose tolerance (OGT) test of two-hour blood glucose or a random blood glucose of 140 mg/dl–199 mg/dl

Risk Factors for Diabetes and Prediabetes

According to an important national clinical trial known as the Diabetes Prevention Program (DPP), the risk factors for prediabetes are the same as those for diabetes:

  • Weight
    The more overweight you are, the more resistant your cells become to insulin. Ask your doctor what a healthy weight for you would be.
  • Waist Size
    The circumference of your waist may be a risk factor for metabolic disease or insulin resistance. A waist measurement of 40 inches or more in men and 35 inches or more in women suggests an increased risk.
  • Sedentary Lifestyle
    Regular exercise reduces your chances of developing diabetes. Physical activity burns glucose as energy, makes cells more sensitive to insulin, and helps maintain a healthy body weight.
  • Age
    The risk of developing prediabetes rises as you get older, especially after age 45.
  • Family History
    The risk of diabetes increases if a parent or sibling has type 2 diabetes.
  • Race
    Due to genetics, African-Americans, Hispanics, American Indians, Asian Americans, and Pacific Islanders are more likely to develop diabetes.
  • Gestational Diabetes
    Women who develop gestational diabetes during pregnancy have an increased risk of diabetes.
  • Polycystic Ovarian Syndrome
    Women who have been diagnosed with polycystic ovarian syndrome have a greater risk of developing diabetes.
  • Sleep Issues
    Research has linked sleep issues such as obstructive sleep apnea with insulin resistance. People who work the night shift are also thought to be at higher risk of developing diabetes.
  • High Blood Pressure
  • Low Levels of HDL ("good" cholesterol)
  • Cardiovascular Disease and Its Warning Signs
    These include high blood pressure, decreased HDL cholesterol, and increased LDL cholesterol and triglycerides.

Lowering Your Risk of Developing Type 2 Diabetes

According to the American Diabetes Association, research shows that you can lower your risk of developing type2 diabetes by 58 percent if you take these preventive measures:

  • Lose 7 percent of your body weight.
    Even a 10- to 15-pound weight loss can make a big difference. In addition to helping reduce your risk of developing type 2 diabetes, losing weight lowers your risk of heart disease and lowers blood pressure, cholesterol, and blood glucose.
  • Eat wisely.
    For a fresh approach to your diet, choose more vegetables, fruits, and whole grains. Substitute quinoa, barley, brown rice, or whole-wheat pasta for white rice or pasta. Buy leaner meats, such as chicken, turkey, and leaner cuts of beef or pork. Save money—and calories—by passing on the soda, sweets, cookies, chips, and other “junk foods.” When you go out to dinner, avoid fried foods and ask for sauces and dressings on the side. Instead of caloric sides such as fries or potato salad, ask if you can substitute fruit, salad, veggies, or sliced tomatoes.
  • Exercise moderately 30 minutes a day, five days a week.
  • Practice stress management techniques.
    Try yoga, meditation, massage, and acupuncture or similar activities.

Note: Our Integrative Wellness Center offers individual fitness counseling, as well as classes and services for stress management. This is a great way to jump-start transition to long-term, healthy behaviors.

SOURCES:

  1. CDC: http://www.cdc.gov/diabetes/basics/prediabetes.html
  2. CDC: http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
  3. ADA: http://www.diabetes.org/diabetes-basics/diagnosis/