Some 86 million Americans are living with prediabetes — and many of them won’t find out unless the disease progresses to full diabetes or if they experience a dramatic symptom like a heart attack.
Prediabetes means that an individual’s glucose levels are too high, but not high enough to indicate diabetes; it also used to be called borderline diabetes.
At specialist conferences, physicians are debating whether prediabetes should be included in the definition of diabetes.
Studies suggest that 5% to 15% of people who are prediabetic will have diabetes within 10 years. Some people assume that prediabetes is benign, but actually it doubles your risk of cardiovascular problems and cardiac events requiring hospitalization.
Identifying prediabetes early is your best opportunity to prevent these outcomes.
Doctors now also recognize a spectrum of related health problems that precede diabetes. Metabolic risk factors like high blood pressure, excess weight, abnormal cholesterol and high triglycerides can act together to cause insulin resistance and prediabetes. If your insulin resistance worsens, you can develop diabetes.
Both prediabetes and diabetes are diagnosed by measuring blood glucose levels with a hemoglobin A1C test. The American Diabetes Association (ADA) sets the criteria for prediabetes as any number between 5.7 and 6.4. A reading below 5.7 is normal; 6.5 and above is considered to be diabetes.
Men and women are equally affected by prediabetes and diabetes, though they can present differently. For example, women are at risk of developing gestational diabetes during pregnancy.
And ethnic minorities have a higher risk of diabetes, including Native Americans, blacks, Asians and Latinos.
Universal screening for diabetes is recommended for all people starting at the age of 45 and for anyone below 45 who is overweight or obese, has a family history of diabetes, or has high blood pressure or cholesterol.
If you’re wondering about your diabetes risk, the ADA website has a free risk test that takes less than five minutes.
One of the challenges posed by these diseases is that there may not be any symptoms at all, although some people with prediabetes have warning signs like neuropathy, a tingling sensation in the feet, or cardiovascular problems. An estimated 8 million Americans have diabetes and don’t know it.
That’s why screening is so important. If you’re diagnosed with prediabetes, there’s still time to do something about it.
A large diabetes prevention program compared two groups of people with prediabetes. One group received Metformin, a medication that lowers blood sugar, and the other made lifestyle modifications-they exercised, ate a nutritious diet, and had coaches supporting them. Thirty percent of the people taking Metformin and 58% of the people in the lifestyle group did not develop diabetes over a three-year period.
People ask me all the time if there is a diabetic diet, but there is no single answer. Patients with diabetes need to balance their diets by emphasizing nutritious foods — fruits, vegetables and whole grain-foods — and avoiding sugary foods, such as candy and sweet drinks.
Programs like the Mediterranean Diet, Dash Diet and Weight Watchers can all be helpful. Losing even small amounts of weight, like 5 or 10 pounds, can make a profound impact on your health.
Prediabetes is a real problem, but it’s also an opportunity to manage the contributing factors, whether it’s weight, blood pressure, or a sedentary lifestyle.
A score of 5.7 and above on the hemoglobin A1C test is a clear sign that it’s time to make lifestyle modifications.
If you have prediabetes, you still may be able to prevent getting diabetes. Now is the time to watch your diet, exercise and your weight.
Jerome V. Tolbert, MD, PhD, is Assistant Professor (pending) of Medicine, Endocrinology, Diabetes, and Bone Disease at Mount Sinai Beth Israel.
[The content provided through this article and www.nydailynews.com should be used for informational purposes only and is not intended to be a substitute for professional advice. Always seek the advice of a relevant professional with any questions about any health decision you are seeking to make.]
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