What is prediabetes?

And why should I care?

Untreated diabetes can kill you. In the Twin Cities, 90,000 adult Blacks have prediabetes and are unaware of it. There are excellent treatments and interventions for prediabetes, but you must find out if you have prediabetes before you can do anything about it. 

An estimated 96 million (36.5%) American adults have prediabetes. An estimated 15.8 million (38.6%) Black, non-Hispanic American adults have prediabetes. Among those with prediabetes, 80% are not aware of it. 

A person is prediabetic when their blood sugar is elevated. A person’s blood sugar level is higher than normal in prediabetes but not high enough to be considered diabetes. Prediabetes is often asymptomatic, so people can have it for years without knowing. 

Additionally, the lack of severe symptoms makes people feel less inclined to make healthy changes to prevent the progression of prediabetes to diabetes, since they feel fine.

Why should I care?

Prediabetes is a crucial point in the progression of diabetes, as it is the last chance to prevent diabetes. It usually takes about five years for prediabetes to develop into diabetes. This five-year period offers an excellent opportunity to make a positive health change. 

 How does insulin affect diabetes?

Insulin is a hormone produced by the pancreas that controls the amount of sugar (glucose) in your bloodstream at any moment. Insulin also helps store glucose in your liver, muscles and fat. Insulin binds to the surface of cells and tells them to let sugar inside. 

Diabetes occurs if your blood glucose (blood sugar) exceeds a certain level regularly. It is a chronic condition that leads to many complications and damage to many vital organs, including heart, eyes, kidneys, brain and skin.

Diabetes can produce cardiovascular problems, such as strokes and heart attacks, and it can change the blood vessels in the eyes, causing blindness. Diabetes can affect the skin, causing ulcers and sores that don’t heal. Diabetes is the most common cause of kidney disease leading to rampant kidney dialysis.

These are just a few reasons why it is so important to know if you are prediabetic and at risk for developing diabetes so that you can make the appropriate lifestyle changes to control your blood sugar and prevent diabetes.

What causes diabetes?

Simply put, being overweight. Diabetes results due to a combination of two factors. The first is insulin resistance, combined with a decrease in insulin secretion by the pancreas. This causes sugar to build up in your blood and results in diabetes. 

Prevention

Step one in preventing prediabetes from developing into diabetes is determining if you have prediabetes. Check with your doctor to see how frequently you should have check-ups and ask your doctor when you should screen for prediabetes. If appropriate, your doctor can do a blood test to determine if you have prediabetes. 

Another test often mentioned in TV ads is Hemoglobin A1c (A1c). This test measures how high your sugar level has been over the past three months. Factors that increase the risk of prediabetes include being overweight, having a family history of diabetes, and having a personal history of high blood pressure.

The risk of developing prediabetes increases gradually as you get older starting around age 45. Once you reach age 65, the risk increases tremendously. It is estimated that over half of people over age 65 have prediabetes, while 25% over 65 have diabetes. 

Different populations have an increased risk for prediabetes. African Americans, Hispanic/ Latino Americans, American Indians, Asian Americans, and Pacific Islanders are at a higher risk for type 2 diabetes.

Lifestyle also impacts the risk of prediabetes. Exercising three times a week can decrease your chances of developing prediabetes. Being active helps your body use insulin to lower blood sugar, and when you are not physically active, insulin cannot control blood sugar levels. 

Lifestyle changes

Once you know you have prediabetes, the next step is to make lifestyle changes to prevent prediabetes from developing into diabetes. The main factors that make the most significant difference in diabetes prevention are a healthy diet, weight loss, and exercise. 

To prevent diabetes, you should follow a diet that minimizes blood sugar spikes, such as foods with a low glycemic index. These foods are digested, absorbed, and converted to sugar slowly and do not dramatically increase your circulating blood sugar. 

Foods with a low glycemic index include whole grains, fruits, vegetables, lean protein, and healthy fats such as salmon and avocado. Consider a diet low in carbohydrates and high in natural foods.

Regular physical activity, at least 150 minutes a week, will help prevent diabetes. A brisk walk or bike ride five days a week for 30 minutes a day would help you meet this goal. 

Losing weight is another thing you can do to prevent the progression of prediabetes to diabetes. Losing about 5% to 7% of your body weight, which would amount to just 10 to 14 pounds for a 200-pound person, can make a big difference in preventing diabetes. 

Doctors have excellent pharmacologic programs and associations with dieticians and fitness consultants to develop a plan to help you prevent diabetes and live your healthiest life. Call your doctor if you suspect you have prediabetes or have not had a general medical exam in two years. 

In the meantime, select one small change you can make in your daily life, such as substituting a sugary beverage with water, taking the stairs instead of the elevator at work, or eating fruit for dessert instead of a baked good. Small changes in your everyday life can make a huge difference in preventing diabetes.