You may have heard that November is National Diabetes Month. If you have diabetes, every month is diabetes month. This is something that you live with and manage every day of the year. If it’s any comfort, know that you’re not alone: According to the Centers for Disease Control (CDC), 29 million Americans have this condition and the numbers are expected to increase.
Twenty nine million people with diabetes is a heck of a lot of people. What you might not realize, however, is that 86 million people in the U.S. have prediabetes, a condition in which blood sugar levels are higher than normal but not high enough to be considered diabetes. Maybe you, your spouse or a parent fall into this category. It’s kind of a gray area if you do. You know you have “something” but it’s not diabetes. What does it mean to have prediabetes? Is it serious? And can you do anything about it?
Why should you care about having prediabetes?
Years ago, doctors often used the term “borderline” diabetes, or might mention that your blood sugar is “a little high.” Before the official term of prediabetes was used, this condition was often downplayed. It’s important to understand that prediabetes is a serious condition, as many people with prediabetes go on to develop type 2 diabetes within 10 years.
How do you know if you have prediabetes?
As previously mentioned, having prediabetes means that your blood sugar (glucose) is higher than it should be. It’s a sign that your body either isn’t making enough insulin (the hormone needed to help lower blood sugar) or your insulin isn’t working the way that it should. As a result, blood sugar levels begin to climb. Keep in mind that you may not feel anything unusual if this is happening. That’s why it’s important to get checked for prediabetes and diabetes regularly at your doctor’s office. All it takes is a simple blood test. Here are three tests that your doctor may use, along with the results that indicate prediabetes or diabetes:
A1C (hemoglobin A1C or HbA1C): Prediabetes is indicated by a result of 5.7 to 6.4 percent. Diabetes is 6.5 or higher. A normal result is about 5.
Fasting Plasma Glucose: A result of 100 to 125 md/dl indicates prediabetes. Diabetes is 126 or higher. Normal is 99 or lower.
Oral Glucose Tolerance Test (OGTT): 140 to 199 mg/dl indicates prediabetes. Diabetes is 200 or higher. Normal is 139 or lower.
What are the risk factors for prediabetes?
There are certain factors that put you at higher risk for having prediabetes. Make sure to get checked if you:
• are 45 years of age or older
• have a parent, brother or sister with diabetes
• are not physically active
• have had a baby weighing more than 9 pounds
• have had gestational diabetes (diabetes that develops during pregnancy)
• have high blood pressure—140/90 mmHg or higher
• have a good (HDL) cholesterol level below 35 or a triglyceride level above 250
• have heart disease
What can you do if you have prediabetes?
My advice is to view a diagnosis of prediabetes as a wake-up call. You have a chance to beat this condition. We know from a landmark study called the Diabetes Prevention Program (DPP) that with lifestyle changes, people at risk for diabetes can lower their risk by up to 58% - that’s phenomenal! Of course, there’s no guarantee that you won’t get diabetes, but you sure can try. Granted, changing your lifestyle is easier said than done; hopefully doing so can empower you to take control. Talk to your doctor and perhaps a dietitian about what you can do to manage your prediabetes and stop diabetes in its tracks. In the meantime, here are a few ways to get started:
• If you’re overweight, try to lose between 5 and 10% of your weight. That’s 10 to 20 pounds if you weigh 200 pounds.
• Become and stay active. Make physical activity a mainstay of your life. Choose something that you like to do, or at least will tolerate – walking, swimming, dancing or exercising to videos on YouTube are some options.
• Focus on your food. Use the plate method to help you balance your choices: fill half of your plate with vegetables, one quarter with a lean protein food, and one quarter with a healthy carb food (brown rice, sweet potato, whole wheat bread). Include a piece of fruit and some healthy fat, such as olive oil, nuts or avocado.
• If you need to, work with your doctor on getting your blood pressure and LDL (bad) cholesterol numbers in a safe range.
• If you smoke, make a plan to stop.
• If you aren’t sleeping well, the above steps can help. You may also have a condition called sleep apnea, so speak with your doctor. Poor sleep quality can raise your chances of getting type 2 diabetes.