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Do you have prediabetes?

Lifestyle changes may delay or prevent serious illness

The vast majority of people with prediabetes don’t know it.

Prediabetes is a condition that can lead to type 2 diabetes and other serious conditions including heart attack and stroke. The condition classified as prediabetes means your blood glucose (sugar) is higher than normal, but not high enough to be called diabetes. Before people develop type 2 diabetes, they almost always have prediabetes.

I have a son in his early 40s who didn’t see any reason to be screened for diabetes because he had been healthy all of his life. A few months ago he became extremely ill, went to the emergency room, and was found to have a very high blood glucose level. After being hospitalized for 10 days and nearly dying, he was diagnosed with type 2 diabetes.

No Clear Symptoms

People usually find out that they have prediabetes when being tested for diabetes–both can be diagnosed with a simple blood test. During a routine office visit your health care provider can order screenings that indicate prediabetes as follows:

  • An A1c (a test that measures average blood glucose for the past 2-3 months) of 5.7 – 6.4 percent
  • Fasting blood glucose (FPG) of 100 – 125 mg/dl
  • An oral glucose tolerance test (OGTT) 2-hour blood glucose of 140 mg/dl – 199 mg/dl

If you have prediabetes, you should be checked for type 2 diabetes after six months to one year and be retested annually. The good news is evidence indicates people with prediabetes can take steps to prevent or delay complications that are linked to diabetes. For some people with prediabetes, early treatment can actually return blood glucose levels to the normal range.

Who Should Get Screened?

The American Diabetes Association recommends that the following people be screened:
Adults of any age who are overweight or obese with one or more of these risk factors:

  • Having a parent, brother or sister with diabetes
  • Low HDL (good) cholesterol level and high triglycerides level
  • High blood pressure
  • History of diabetes during pregnancy or having a baby weighing more than 9 pounds
  • Being inactive
  • History of cardiovascular disease
  • Belonging to an at-risk ethnic group (African American, Hispanic, Native American, Hispanic American, Asian American or Pacific Islander)
  • Previous blood test showing prediabetes
  • People aged 45 or older without any risk factors
  • Overweight children aged 10 years and older who have two of these risk factors:
  • High body mass index (BMI) based on child’s weight and height
  • Family history of diabetes
  • Signs of insulin resistance or having a condition associated with insulin resistance
  • At-risk ethnic background
Preventing Type 2 Diabetes

You will not develop type 2 diabetes automatically if you have prediabetes. Research shows that you can lower your risk for type 2 diabetes by 59 percent by making lifestyle changes that include:

  • Losing 7 percent of your body weight (or 15 pounds if you weigh 200 pounds)
  • Exercising moderately (such as brisk walking) 30 minutes a day, five days a week

In addition to weight loss and physical activity, your doctor will also recommend that you make changes to your diet that may include eating more fruits, vegetables and whole grain foods. You should also limit your consumption of sugar-sweetened beverages. If you drink alcohol, limit yourself to two drinks per day for men and one drink per day for women.

Even if you can’t reach your ideal body weight, losing even 10 to 15 pounds can make a big difference. Work with your health care provider to avoid diabetes and its complications. Eating right, staying active and taking any needed medications can help you stay healthy.

I am pleased to report that my son is now controlling his diabetes by following a healthful diet, engaging in regular physical activity, taking medication and monitoring his blood glucose levels twice daily. He has succeeded in losing 20 pounds and feels much better since he has made appropriate lifestyle changes.

Please be screened and follow your health care provider’s recommendations to enjoy better overall health. Check the Alabama Department of Public Health website at adph.org/diabetes for information and educational opportunities in your area.

Jim McVay, Dr.P.A., is director of the Bureau of Health Promotion and Chronic Disease of the Alabama Department of Public Health.