PREDIABETES

What is prediabetes?

Glucose (also known as blood sugar) is produced by the body from the foods that you eat (and some by the liver). Insulin, a hormone produced by the pancreas, takes the sugar from the bloodstream and carries it to your cells where it is used for energy. This process controls the amount of sugar in your blood, keeping it from getting too low or too high.

Prediabetes is a condition in which your body becomes resistant to the effect of insulin and doesn't take up sugar from the bloodstream as it normally would. This causes the levels of blood sugar to become higher than normal. Over time, having too much sugar in your blood puts you at risk for heart disease and stroke, and for developing type 2 diabetes.

Who is at risk of developing prediabetes?

According to the Centers for Disease Control and Prevention about 41 million American adults have prediabetes. Sadly, as the population has become more overweight and inactive, the number of children and young adults with prediabetes is also rising.

Risk factors that increase your chances of developing prediabetes include:

· Being overweight or obese

· Lack of exercise

· Family history of type 2 diabetes

· Age 45 years or older (but younger people, including children and adolescents are now at risk)

· Race (rates of diabetes are higher in African Americans, Latinos/Hispanics, and American Indians)

· Gestational diabetes (diabetes during pregnancy) or giving birth to a baby weighing more than 9 pounds

How do you know if you have prediabetes?

Prediabetes has no visible signs or obvious symptoms. Two blood tests are used to check the levels of sugar in your blood and diagnose this condition:

· Fasting blood glucose test (FBG) — Blood is drawn after you fast (go without food) overnight or for at least 8 hours.

· Oral glucose tolerance test (OGT) —This test requires that you fast for at least 8 hours. Blood is drawn before you drink 8 ounces of a sugary solution and 2 hours after. (If your blood sugar is between 140 to 199 mg/dL after 2 hours, you have impaired glucose tolerance, a prediabetes condition.)

Normal FBG: 70 to 99 mg/dL OGT: Under 140 mg/dL

Prediabetes FBG: 100 to 125 mg/dL OGT: 140 to 199 mg/dL

Diabetes FBG: 126 mg/dL and higher OGT: Higher than 200 mg/dL

Why should prediabetes be taken seriously?

Each year about 1 out of 10 patients (or 10%) with prediabetes develops type 2 diabetes.

If left untreated, diabetes can cause blindness, kidney failure, nerve damage, heart disease, stroke, and high blood pressure. Even when blood sugar levels are slightly high, as they are with prediabetes, your risk for cardiovascular disease increases.

How do you prevent and treat prediabetes?

Prevention of prediabetes (and type 2 diabetes) is possible even if diabetes runs in your family. In most people with prediabetes, progression to diabetes can be avoided with lifestyle changes that include:

· Eating a balanced meal plan, low in fat and high in fruits, vegetables, and whole grains

· Getting regular physical activity (a half-hour five times a week)

· Maintaining a healthy weight (if you are overweight or obese, losing just 5% to 10% of your weight may help you dramatically lower your chances of developing type 2 diabetes)

While lifestyle changes are the first choice to treat prediabetes and prevent diabetes, medications may be an option to be used in combination with diet and exercise. If medication is considered, several drugs have been proven to lower the risk of progression to diabetes including metformin, rosiglitazone, pioglitazone, and acarbose. Because of the relationship between type 2 diabetes and obesity, medications that help with weight loss may also lower the risk of developing diabetes.

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