Diabetes & Related Conditions - Pre Diabetes

When you have pre–diabetes, your blood sugar (glucose) is higher than normal, but not high enough to be considered diabetes. The problem is that this condition puts you at a higher risk of getting diabetes. Diabetes is more than a "touch of sugar." It is a serious disease that can negatively affect your health in many ways. Today over 25 million Americans have diabetes. But even greater numbers of Americans have pre–diabetes. And the numbers continue to grow. 

Is it a new condition?
Pre–diabetes is a new name for an old condition. It used to be called "impaired glucose tolerance" (IGT) or "impaired fasting glucose" (IFG). These terms also mean that blood glucose levels are a bit raised. We know much more about this condition today. 

Pre-diabetes is a health problem
Having pre–diabetes means you are at high risk for developing type 2 diabetes. About half the people who have pre–diabetes, develop type 2 diabetes within 10 years. But even pre–diabetes can have bad effects on your health. For example, people with pre–diabetes have 1.5 times more risk of heart and blood vessel disease. This includes high blood pressure, stroke, and heart attack. 

Diabetes can be prevented
When you have pre–diabetes and make lifestyle changes, it is possible to prevent or delay type 2 diabetes. In a national study called the Diabetes Prevention Program, doctors looked at a large number of overweight people who were at high risk for diabetes. Here is what they found: Losing weight and being physically active can prevent or delay type 2 diabetes. 

How likely am I to get pre-diabetes?
The same risk factors increase your chances of getting pre–diabetes or diabetes. You are more likely to get pre–diabetes or diabetes if you:

• Have diabetes in your family
• Are a member of a minority group, including African American, Native American, Latino, or Pacific Islander
• Are overweight or obese
• Have high blood pressure
• Have high blood fats, called cholesterol (co–LESS–ter–all) and triglycerides (try–GLISS–er–ides)
• Are not physically active
• Had high blood glucose when pregnant; this is called gestational (jess–TAY–shun–ol) diabetes
• Gave birth to a baby weighing more than 10 pounds

What symptoms should I look for?
Often there are no symptoms when you have pre–diabetes. You can have pre–diabetes without knowing it. You could even have diabetes and not know it. Millions of people do. Some of the symptoms of diabetes are:

• Extreme thirst
• Passing water (urinating) often
• Blurred vision
• Extreme tiredness for no known reason

How can I find out if I have pre-diabetes?
There are several blood tests that your physician can ask you to complete to detect pre–diabetes. One is the FPG (fasting plasma glucose test). Another is the OGTT (oral glucose tolerance test). For either test, you must fast overnight. This means you can have no food or liquids for 8 hours before the test. If you have the FPG, your blood glucose is tested once. If you have the OGTT, your blood glucose is tested twice. It will be tested after you fast. Then you will drink a sugar–rich liquid, and your blood glucose will be tested 2 hours later. Any abnormal result should be confirmed with a repeat test. Another test that can determine pre-diabetes and does not require fasting is called glycohemoglobin A1c. 

The American Diabetes Association defines pre-diabetes as:

• A fasting plasma glucose result of 100-125mg/dl on two separate occasions OR
• A two-hour glucose result (during oral glucose tolerance test) of 140-199mg/dl on two separate occasions OR
• A glycohemoglobin A1c result of 5.7-6.4%

Should I be tested?
Ask your doctor about pre–diabetes testing. Your doctor will tell you if you should have a test. Here are the test guidelines from the American Diabetes Association (ADA): 

You should consider testing if you are:

• Over age 45
• Under age 45 and overweight
• Under age 45 and have 1 or more risk factors (see "How likely am I to get pre–diabetes")

Testing is strongly recommended if you are:

• Over age 45 and overweight

How often should I be tested?
If your results show blood glucose in the normal range, get tested every 3 years.
If your test results show that you have pre–diabetes, get tested every 1 to 2 years. 

What do I do for pre-diabetes? 
When you have pre–diabetes, take steps to delay or prevent diabetes. It´s very important to eat a healthy diet and to be physically active. Losing a small amount of weight and getting more physical activity can make a big difference. Take these steps:

• If you are overweight, lose at least 5 to 10 percent of your body weight. Reduce the number of calories in your diet. Lower the amount of fat in your diet.
• Increase your physical activity. You don´t need a fancy routine. Just move your body to burn calories. Take a brisk walk for 30 minutes every day. Play outdoors with your kids or grandkids. Work in the yard. Always check with your doctor before you start a new fitness program.
• Ask your doctor about the risk factors for heart disease or stroke. Smoking, high blood pressure, and high cholesterol are some of these risk factors. Ask about treatment or counseling for any risk factors you have.

Can I get help to manage pre-diabetes?
To manage pre–diabetes, you will need a plan. Talk to members of your health care team. They will help to design an overall plan for managing your pre–diabetes.

• Your primary doctor can provide testing and decide on the best way for you to prevent or delay diabetes.
• A diabetes educator can give you information on how to control your blood glucose levels.
• A dietitian can help you lose weight by finding a meal plan that can work well for you.
• An exercise physiologist (fizz–ee–ALL–oh–jist) can design a physical activity plan to help you lose weight and gain energy.
• The Diabetes Prevention Support Center offers the Group Lifestyle Balance^TM program for individuals with pre–diabetes and/or the metabolic syndrome.

Act now!
If you act now, you can reduce your chance of diabetes, stroke, or heart disease in the future. If you have questions about pre-diabetes or the Group Lifestyle Balance^TM program, please contact us.