Pre-diabetes and how to prevent the progression to Diabetes
Pre-diabetes is becoming more common in the United States, according to estimates provided by the U.S. Department of Health and Human Services (DHHS). pre-diabetes affects 79 million people age 20 or older in the U.S., according to the American Diabetes Association (ADA). Many individuals with pre-diabetes go on to develop type 2 diabetes within 10 years.
Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some individuals have both IFG and IGT. In IFG, glucose levels are a little high when it has been several hours after eating. In IGT, glucose levels are a little higher than normal right after eating.
Pre-diabetes is characterized by an increased level of glucose in the bloodwhich is also a possible sign of metabolic syndrome. When you have pre-diabetes, your risk of developing diabetes increases. Your chance of developing heart disease and stroke goes up, too. The good news is that you can help control and possibly reverse pre-diabetes by making some basic lifestyle changes.
When it's pre-diabetes
Insulin is a hormone that helps cells turn glucose into energy. When the body's cells don't use insulin properly, you have insulin resistance. It can cause glucose to build up in the blood.
Glucose levels are measured using a fasting glucose test or a glucose tolerance test. According to the American Diabetes Association, you have pre-diabetes if your fasting glucose result ranges from 100 to 125 mg/dL, or your glucose tolerance result ranges from 140 to 199 mg/dL, or your A1C level is 5.7 to 6.4 percent.
Type 2 diabetes
According to 2011 data from the CDC, more than 28.5 million people, or 8.3 percent of the U.S. population, have diabetes. This puts them at increased risk for heart disease, limb amputation, blindness, and other serious health conditions. Fortunately, type 2 diabetes—the most common type of diabetes—can be prevented. You may be able to reverse its course if you make the right lifestyle choices.
The telltale signs
The warning signs of uncontrolled diabetes include excessive thirst and frequent urination, constant hunger, unexplained weight loss, and numbness or tingling sensations in the hands and feet. Often, diabetes and pre-diabetes can arise without any clear symptoms. In some cases, a person's body shape can be a clue. Carrying an excess amount of weight around the waist, or having an apple-shaped figure, has been linked to pre-diabetes and type 2 diabetes.
According to the National Diabetes Information Clearinghouse, women who have a waist measurement of more than 35 inches, and men whose waist size is more than 40 inches, are particularly at risk for diabetes.
Dark patches of skin that develop behind the neck and on the elbows or knees may also be a warning sign of pre-diabetes. These dark patches are the result of having excess insulin in the body. For women, excess facial and body hair, irregular menstrual cycles, severe acne, and fertility problems may also be signs of the condition.
Risk factors
The risk for diabetes and pre-diabetes increases with age. The ADA recommends blood glucose screening for everyone at age 45. People younger than age 45 should also talk with their health care provider about getting tested for diabetes or pre-diabetes, particularly if they have one or more of the following risk factors:
- Weight. Being overweight or obese is one of the most common risk factors for pre-diabetes. Approximately 80 percent of people who have type 2 diabetes are overweight.
- Inactivity. Being inactive or exercising fewer than three times a week increases your risk for diabetes even if your weight is normal.
- Family history. Having a parent or sibling with type 2 diabetes increases your risk for disease.
- Race. Although it's unclear why, people from certain ethnic backgrounds are at increased risk for diabetes, including African Americans, Asian Americans, Hispanics, American Indians, and Pacific Islanders.
- High blood pressure. People who have a blood pressure of 140/90 mm Hg or higher are at increased risk.
- Blood cholesterol and triglyceride levels. People with an HDL ("good") cholesterol level of 40 or lower, or a triglyceride level of 250 or higher, have a higher risk for diabetes.
Lifestyle changes help prevent progression to diabetes
The most important steps to reducing the risk for type 2 diabetes involve changes to diet, exercise, and behavior. If you're at risk for pre-diabetes, you may be able to reverse it through these steps:
- Manage your blood sugar level. Eat a diet that is low in fat, simple carbohydrates (e.g. white pasta, white bread, white potatoes, white rice, processed foods such as crackers, cookies, and cakes), and calories. Focus on vegetables, fruits, and whole grains. Because they are high in soluble fiber, they can help control blood insulin and glucose levels.
- Practice portion control (i.e. eat smaller amounts.)
- Stay active. Get at least 30 minutes of moderate-intensity physical activity most days of the week but preferably every day. Exercise helps reduce insulin resistance.
- Lose excess weight. You can improve your blood sugar level and reduce your risk for cardiovascular disease by losing as little as 5 to 10 percent of your body weight.
Even small lifestyle changes can help reduce the risk for diabetes.