Pay Attention!

Could You Have Pre-Diabetes?

 

About one-third of Americans over age 20 have pre-diabetes, says the Centers for Disease Control and Prevention. Are you one of the people at risk for developing type 2 diabetes? Learn more about pre-diabetes, who should get tested and 4 steps you can take to stop the disease from developing...
Fifty-seven million people in the U.S. are at risk for developing type 2 diabetes – and many don’t know it. The good news: Exercising and eating better can reverse your risk.

This precursor to diabetes shows no symptoms. But your body, especially the heart and circulatory system, may already be suffering long-term damage.

Left undetected, pre-diabetes will likely turn into type 2 diabetes, a chronic disease requiring daily maintenance to manage blood glucose levels. If not, you run the risk of further complications, like nerve damage and heart, kidney or eye disease.

Fortunately, there are several steps you can take to stop it.

A better diet and regular exercise are your best defense. These lifestyle changes can prevent, control, or even reverse high blood glucose levels.

Plus, you should get yearly tests of your levels to monitor progress.

Here, we break down how you can regain control of your health.

What Is Pre-Diabetes?This fairly new term replaces earlier names for the condition: impaired glucose tolerance and impaired fasting glucose.

“The move to the pre-diabetes label signals that this is a serious medical condition – yet there’s still time to do something,” says Aaron Cypess, M.D., Ph.D., a research associate at the Joslin Diabetes Center, a Harvard-affiliated research and clinical care center, who studies obesity and type 2 diabetes.

To be diagnosed with pre-diabetes, your fasting blood sugar (the amount of sugar in your blood after not eating or drinking for eight hours) should be between 100 and 126 mg/DL. This is higher than normal, but not high enough to indicate type 2 diabetes.
Who Should Get Tested?The American Diabetes Association (ADA) has identified the following risk factors for pre-diabetes:

• High blood pressure
• Being overweight, with a body mass index above 25
• Inactivity
• Being 45 or older
• Abnormal cholesterol levels, including a “good” cholesterol (HDL) level below 35 mg/do (0.9 mmol/L) or triglyceride level above 250 mg/dL (2.83 mmol/L)
• A family history of type 2 diabetes
• Being African-American, Hispanic, Native-American, Asian-American or a Pacific Islander
• Having had gestational diabetes or given birth to a baby weighing more than 9 pounds
• A history of polycystic ovary syndrome

Plus, ask to be tested if you have these common diabetes symptoms: excessive thirst, frequent urination or blurry vision. What Tests Can I Expect?The primary blood test for pre-diabetes is the glycated hemoglobin test, also called A1C. This shows your average blood sugar level for the past 2-3 months.

The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level between 6-6.5% is considered pre-diabetes; levels over 6.5% signal diabetes.

Some physicians prefer to check for pre-diabetes with a fasting blood sugar test, done after you don't eat or drink for at least eight hours.

A normal test result shows blood sugar levels lower than 100 milligrams per deciliter (mg/dL); 100-125 mg/dL is considered pre-diabetes; anything over 126 indicates diabetes.

Your doctor may also order an oral glucose tolerance test. In addition to drawing blood after you fast for 8 hours, you then drink an extremely sweet, sugary solution. Two hours later, your blood sugar is tested again.

A reading of 140 mg/DL or under is normal; 140-199 mg/DL is considered pre-diabetes, and 200 mg/dL or higher typically means diabetes. Steps You Can Take to Stop DiabetesIf your doctor suspects you have pre-diabetes, she’ll likely recommend you change your eating and exercise habits and ask you to return in 2-3 months to test your blood glucose levels again.

If your efforts improve lab results, you may be able to skip medication to control your levels.

“My decision to start medications depends on how fast the sugars are going up,” Cypess says.

Changing your routine doesn’t mean you’re doomed to give up your favorite foods and relaxation time.

To help control blood glucose levels, Cypess recommends eating plenty of complex carbohydrates, fruits, vegetables, nuts and proteins that are low in saturated fat.

“I like the Mediterranean diet, but more important is any healthy diet that a patient is willing to follow,” Cypess says.

He even allows for some junk food, in moderation. “I don't think a lifetime of poorer food choices can be changed overnight.”

Here’s how to get started with a healthier routine:
1. Start a successful workout regimenWalking is a great first step for those new to exercise.

It doesn’t require special equipment or a gym membership, and you can do a lot or a little, depending on your goals.

Start slowly, walking about 10 minutes five days a week, according to the ADA. Gradually increase to 20 minutes 5 days a week, then 30 minutes.

These tips will keep you motivated:

• Measure your hips, waist, biceps and thighs before you begin your walking program. Repeat every few weeks to track changes in your measurements the scale doesn’t show.
  
• Tempt yourself with workout music. Set aside favorite songs, podcasts or books on tape and only listen to them while walking.
  
• Choose the right surroundings. Walk outside, rather than on a treadmill. The fresh air and sunshine can give you a whole new lift.
  
• Get a walking buddy. Chatting during your walk makes the time go faster. Plus, if you know your friend is waiting, you’ll be less likely to cancel.
  
• Remember, every step counts. Park your car away from entrances. Stroll down to your neighbor’s house instead of calling her on the phone. Incorporating more movement into your daily routine increases stamina.

2. Stop supersizingDid you know: Since 1960, dinner plates have increased their surface area by 36%, according to the Small Plate Movement, an organization of academics, media groups and the U.S. government striving to help American families lose weight.

And portion sizes have grown to fill the plates. Hamburgers are towering stacks of beef; sodas come in cups you can’t hold with one hand. Restaurant salads come in bowls that could feed the entire family.

Cut the fat and keep prediabetes from worsening with these dining tips from dietitian Sue Robbins, published in Diabetes Forecast magazine:

• Use smaller plates and bowls. This fools your mind into thinking you have more food than you actually do. Use appetizer plates for salads, luncheon plates for dinners, and very small bowls for cereal.
  
• At a restaurant, ask for a doggie bag and put half your meal away before you start eating. You’ll get a proper-size meal and tomorrow night’s leftovers as well. Another idea: Split an entrée with your dining companion.
  
• Repackage snacks into smaller containers. Check the label for the recommended serving size. Then portion out into sandwich bags or plastic containers so you can grab and go.

3. Learn your serving sizesWhen you have pre-diabetes, sticking to recommended amounts of specific foods is vital for keeping blood sugar levels and weight gain in check.

How do you assess what you’re eating? Try these techniques, adapted from What to Expect When You Have Diabetes, presented by the ADA.

Use standard kitchen measuring cups, spoons and food scales to train your eyes to see correct serving sizes. Once you’ve weighed, measured and looked at half cup of green beans or 5 ounces of chicken a few times, you’ll have a mental picture of how big it is.

Every few months, measure some servings again to keep your eyes sharp.

Comparing serving sizes to everyday items can help you remember how much you should eat. Here are guidelines for some food favorites:

• 1 cup of pasta or rice – about the size of a clenched fist
  
• 1/2 cup of vegetables – about the size of half a tennis ball
  
• 1 cup of broccoli – about the size of a light bulb
  
• 3 oz. meat, chicken or fish – about the size of a deck of cards
  
• 1 oz. cheese – about a 1-inch square cube

4. Eat Better Without Blowing Your BudgetFresh produce is an important part of a pre-diabetic’s diet. Prepackaged foods can be costly. But fresh choices don’t have to be.

These guidelines, adapted from What to Expect When You Have Diabetes, will help keep costs down:

• Buy fresh fruits and vegetables. Skip the fruit cups and prepackaged veggies. You’ll save money by buying your produce fresh and cutting them yourself.
  
• Buy fruits in season. When produce is abundant, it tends to cost less. Look for apples and grapes in the fall, citrus in the winter and berries in the spring.
  
• Buy produce directly from the farmer. When food has to be packaged, transported, costs goes up. Buying local also supports your community.

By Nancy Wride, Special to Lifescript