You’ve just completed a routine physical exam…certain of a clean bill of health. That is, until your doctor wants to have “a talk” with you.
Your mind goes round and round in circles. “Is it cardiovascular disease? High cholesterol? Cancer?”
The doctor enters the room with a look of concern. Your heart pounds as she sits down to deliver the news.
“You have prediabetes,” she states.
“Oh thank goodness,” you think. “Why does she seem so worried? Anything with that begins with ‘pre’ can’t be that bad.”
Think again.
This frequent misconception is one of the most concerning health mistakes that Americans make. And the consequences can be life threatening.
Prediabetes is a condition in which fasting blood glucose levels are higher than normal, but not yet high enough to be diagnosed as full-blown diabetes. It is also referred to as borderline diabetes, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT).
These days, prediabetes is becoming all too common. In fact, the number of people living with this disease is alarming. The chances are that you or someone you know has it.
Consider this shocking statistic.
According to the Centers for Disease Control and Prevention (CDC), 86 million Americans have developed prediabetes. That’s nearly one out of three people. Unfortunately, nine out of 10 people are unaware that they have it.
Even more disturbing, 15 to 30 percent of people with prediabetes will develop Type 2 diabetes within five years if recommended lifestyle changes are not made.
Add that to the fact that the term “pre-diabetes” itself throws patients off. This is because patients often assume that the “pre” means there are no potential health consequences associated with this condition.
The harsh reality is that this simply isn’t true.
Not only can prediabetes drastically increase the chance of developing Type 2 diabetes, but it also elevates the risk of heart disease, blood vessel disease, high blood pressure and stroke.
“People with pre-diabetes have up to a 70 percent chance of developing diabetes over their lifetime and can acquire the complications of diabetes even if they don’t develop overt diabetes,” says Dr. Leigh Perreault, a physician and clinical researcher at the University of Colorado Denver School of Medicine.
In recent years, this condition has become an epidemic. In part, this may be due to a lack of parallel guidelines in the medical industry.
“This is likely becoming more common because only the American Association of Clinical Endocrinologists (AACE), not the American Diabetes Association (ADA), has guidelines for people with prediabetes and many health care practitioners do not treat prediabetes,” Perreault says.
“Prediabetes can be diagnosed based on a fasting glucose blood test, blood glucose test after an oral glucose tolerance test (OGTT), or by A1C (which shows your estimated blood glucose level over three months),” Perreault says.
The tests themselves greatly differ. “The blood glucose tests actually measure the absolute amount of glucose in the blood, whereas the A1C is the percent of red blood cells with glucose stuck to them,” Perreault says.
Understanding these results can throw patients for a loop because each test can have different findings that are not necessarily synonymous. “People can also develop prediabetes based on only one factor,” Perreault says. “For example, fasting vs. post-OGTT glucose, which may tell us something about where the problem is starting in the body.”
To know whether or not to be tested, it’s important to consider common risk factors. These include being overweight, 45 years of age or older, a family history of Type 2 diabetes, high blood pressure, sedentary lifestyle and a previous diagnosis of gestational diabetes. Giving birth to a baby nine pounds or more can increase the risk of developing prediabetes.
So what is there to do after receiving a confirming diagnosis?
First and foremost, lose weight if a doctor recommends it. This means adopting a healthy lifestyle based on good nutrition and increased physical activity.
Studies show that losing just 7 percent of body weight and being active for 150 minutes or more a week can decrease the chance of getting full-blown diabetes by up to 58 percent.
That said, certain types of diets may be more effective than others. Sticking to a lower carbohydrate nutritional plan just might be the best option.
“If the goal is weight loss, the clinical trials data is strongest for low carb diets as people lose more weight and keep it off more successfully,” Perreault says.
She reminds patients not to forget to add exercise to a daily routine, which increases chances of success.
“Exercise is the best predictor for weight loss maintenance-working up to 45 minutes a day,” Perreault says.
Rather than jumping into a routine with no preplanning, consider the overall picture. “I ask my patients to pick a training goal – something they can’t go out and do today – put in on the calendar and work toward it,” Perreault says.
That’s because a lack of planning can sabotage the chance of success and of sticking with a new program. “I spend a lot of time helping patients overcome obstacles and making action plans to adopt healthy habits,” Perreault says. “I also do all these things myself!”
Another important factor to consider is added sugar intake. Sugar itself increases blood glucose levels and adds unwanted pounds. The problem is that most Americans don’t know just how much sugar they’re eating.
According to the American Heart Association (AHA), the average American consumes 22 teaspoons of sugar per day. That’s more than 60 pounds of added sugar a year. However, the recommended daily allowance is just six teaspoons for women and nine teaspoons for men.
To decrease sugar intake, make it a priority to learn to read labels. “Sugar can be hidden in processed foods,” says Kristin Lund, a certified health coach specializing in diabetic nutrition. “There are over 60 names used for sugar alone.”
Lund says to look for names like sucrose, barley malt, dextrose, maltose, rice syrup and high-fructose corn syrup. These are all common industry terms for sugar.
Know how much sugar is in common foods and restaurant foods. Be on the lookout for added sugar in sweetened beverages and processed foods.
That said, Perreault says she doesn’t necessarily tell patients to watch sugar intake.
“If they do a low-carb diet, this is implicit,” Perreault says. “When they are perplexed that they have diabetes or pre-diabetes and tell me they don’t eat much sugar, I tell them these are diseases of over-nutrition – of anything – not just sugar.”