Prediabetes: A too-common—and often undiagnosed—wake-up call
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If you put 10 people in a room, averages would suggest that four of them have prediabetes. If that’s not troubling enough, consider this: The Centers for Disease Control and Prevention say that three of those four people don’t know they have it.
Before you shrug and say, “Well, at least it’s not diabetes,” consider this: Prediabetes comes with many of the same long-term health risks as diabetes. The difference? With prediabetes, a person has a chance to avoid diabetes and can decrease the risks of heart disease, kidney disease, blindness and other issues associated with diabetes.
Avoiding those risks starts with a simple blood test.
As the name suggests, prediabetes is a condition in which a person’s blood sugar level is not high enough to indicate diabetes but appears to be heading that way. However, a prediabetes diagnosis doesn’t mean diabetes is inevitable. On the contrary, it means a person is being given notice that making diet and lifestyle changes could mean avoiding diabetes.
The most reliable way for someone to know if they have prediabetes is to know their blood sugar levels by getting a blood test in a doctor’s office or lab. If the results fall into the range for prediabetes (a fasting plasma glucose reading of 100-125 milligrams per deciliter (mc/dL), an oral glucose tolerance result of 140-199 mg/dL or an A1c result of 5.7% to 6.4%), the test should be repeated and the levels rechecked annually.
A number of factors contribute to prediabetes. Certainly, genetics are involved, but excess body weight is a major factor (especially if it’s carried around the midsection), as are a sedentary lifestyle and smoking. If diabetes runs in the family, the risk for prediabetes is higher, as it is for women who have had gestational diabetes. While prediabetes typically shows up in people older than 45 and increases in likelihood as people age (nearly 80% of 80-year-olds have prediabetes or diabetes), more and more young people are being diagnosed with prediabetes.
The risks associated with prediabetes are serious. Perhaps most obviously, prediabetes can develop into diabetes, which can lead to nerve damage causing chronic numbness and pain, kidney disease, cardiovascular disease, poor wound healing, the need for limb amputation, blindness, and increased risks after surgery.
The good news is that most people could avoid such risks if they view a prediabetes diagnosis as a wake-up call prompting them to make some changes.
While there is no medication approved by the FDA for the treatment of prediabetes, there are many potential interventions, one of which is at once incredibly simple and incredibly challenging: lifestyle changes. By replacing the poor diet and low fitness levels that have become endemic in the U.S., many people could lower their blood sugar levels below prediabetic levels and keep them there.
What would that mean? Put more fruit and vegetables on the dinner table, eat less snack food and dessert, limit portion sizes, cut back on high-carb foods, and recognize that one large soda or supersized dinner can create a major setback. For example, downing one 16-ounce lemonade will undo the benefits of a mile-and-a-half walk, and one big meal can offset a week’s worth of self-control.
Also, get more exercise, understanding that you don’t have to become an Olympic athlete to benefit. Taking a walk, working in the garden, riding a bike or other simple activities for 30 minutes a day five days a week can make a difference.
The added benefit? In addition to having a direct impact on the chances of being prediabetic, such changes also can reduce body weight, which is a key factor in prediabetes and other health conditions. In fact, the CDC suggests that losing 5% to 10% of body weight cuts the chance of developing diabetes by half. Finally, stop smoking. Cutting back isn’t sufficient for keeping diabetes at bay.
Patients also should be aware that most insurance providers – including MDwise – have disease and care management teams that help you navigate life after a prediabetes diagnosis, and the CDC offers the National Diabetes Prevention Program, which supports patients undertaking lifestyle changes.
Of course, none of these measures can be pursued if someone has prediabetes and doesn’t know it. That’s why everyone should talk with a caregiver about their blood sugar levels, and if they haven’t been tested recently, they should get a test as soon as possible.