Prediabetes Diagnosis is a ‘Gift’ — November 2016


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Taking Measures to Reduce Risk for Diabetes

More than 29 million Americans live with diabetes — a serious condition in which blood glucose (sugar in the blood) builds to dangerously high levels. What’s more, another 86 million live with prediabetes, that is, have strong risk factors for developing type 2 diabetes. The Center for Disease Control states that 90% of people with prediabetes don’t know they have it!

“A diagnosis of prediabetes is a gift and a wake-up call,” says Marilyn Novosel, MPH, RN, CDE, the Certified Diabetes Educator for KnovaSolutions. “Learning that you have risk factors for developing diabetes is an opportunity to do something about it sooner rather than later.” She adds that making lifestyle changes can slow the progress, reduce the possibility of long-term complications, and for some, return blood sugar levels to normal.

What is Diabetes?

Diabetes is a disorder of the endocrine system in which the pancreas makes too little or no insulin (type 1 diabetes) or can’t use insulin effectively (type 2 diabetes). When you eat, the pancreas secretes insulin into your blood. Insulin is responsible for carrying sugar to the body’s muscles and other tissues for energy. When there isn’t enough insulin or it can’t be used properly, sugar builds up in the blood and damages nerves and blood vessels. This can lead to heart disease, stroke, kidney disease, blindness, dental disease, neuropathy, and the need for amputation of legs, feet or toes.

Most (95%) of the people with diabetes have type 2 diabetes, formerly called adult-onset diabetes. It can develop at any age but its most common onset is at 45 years or older, and among those who are overweight and inactive. Type 1 diabetes, also called juvenile diabetes, is usually diagnosed during childhood or among young adults.

What is Prediabetes?

If you have prediabetes, it means that the sugar level in your blood is higher than normal, but not high enough to be considered diabetes. Having prediabetes means that the long-term damage to your heart and blood vessels may have already started. Without some intervention, prediabetes will likely become diabetes in 10 years or less, according to the Mayo Clinic. But fortunately, prediabetes does not have to become diabetes!

Many who have prediabetes may not even know it since there are often no symptoms. However, one possible signal is darkened skin on the neck, armpits, elbows, knees and knuckles. Other signs that blood sugar may be high include increased thirst and hunger, frequent urination, weight loss, fatigue, blurred vision, slow-healing sores and/or frequent infections.

Preparing for Appointments

When seeing your healthcare provider for prediabetes evaluation, it helps to be prepared!

  • Find out if you should not eat for 8 hours before your appointment time. Your provider may want to do a fasting blood sugar test.
  • Make a list of your symptoms.
  • Carry a list of your medications and supplements.
  • Write down your questions so you have a handy reference.

Diagnosis

Your healthcare provider can test your blood to determine your blood glucose levels. Prediabetes (and diabetes) is diagnosed and monitored with the following blood tests. More than one test may be used, depending upon your circumstances. If you have risk factors (see box), it is worth discussing testing with your provider.

  • A1C test measures your average blood glucose for the previous three month period. Prediabetes: 5.7-6.4%; diabetes: 6.5% and above; normal: less than 5.7%.
  • Fasting plasma glucose (FPG) calculates blood sugar levels on an empty stomach. Prediabetes: 100-125 mg/dl; diabetes: 126 mg/dl and above; normal: less than 100 mg/dl.
  • Oral glucose tolerance test (OGTT) measures blood sugar before and two hours after drinking a sugary solution. Prediabetes: 140-199 mg/dl; diabetes: 200 mg/dl and above; normal: less than 140 mg/dl.

Prediabetes/Diabetes Risk Factors

  • Being 45 years or older.
  • Carrying excess weight, such as body mass index (BMI) over 25. Check your BMI here.
  • Having a family history of diabetes.
  • Living an inactive lifestyle.
  • Having high blood pressure, low HDL cholesterol (the “good” kind), and high triglycerides, a type of fat in blood.
  • Having had gestational diabetes or given birth to a baby who weighed more than 9 pounds.
  • Being of African American, Hispanic, Latino, Native American, Pacific Island, and Asian American descent.
  • Having polycystic ovarian syndrome.

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Many studies show that healthy lifestyle choices can help bring blood sugar levels back to normal, or at least keep them from rising. You can reduce your risk for diabetes (and many other conditions) with these lifestyle changes:

  • Get moving. Shoot for 30-60 minutes of moderate activity (walking, biking, swimming, dancing, gardening, exercise class) most days of the week. It’s best not to let more than 2 days pass without exercise.
  • Lose excess weight. Losing 5-10% of your body weight can make a big difference. If you weigh 200 pounds, that is 10-20 pounds.
  • Eat healthy foods such as vegetables, fruits, whole grains and low fat proteins (beans, fish, chicken, nuts, seeds).
  • Avoid high-glycemic foods (foods that raise blood sugar quickly) such as white rice, bread and pasta, and desserts and sweets. Choose fruit and whole grain breads, pasta and cereal instead.

Some tricks that help people lose weight include drinking plenty of water, avoiding alcohol, reducing serving sizes, avoiding eating for comfort or to relieve stress, and keeping an activity and food journal.

Your KnovaSolutions nurse is a great source of information. The Certified Diabetes Educator is available to KnovaSolutions members for consultation too. If you have questions about your symptoms or ways to reduce your risk, give us a call. Our nurses can help you, as well as family members, understand your options and answer your questions. Call 800/355-0885, Monday through Friday, 8 am-5 pm, MT.

The American Diabetes Association website (www.diabetes.org ) offers additional helpful information about prediabetes and diabetes.

We encourage you to leave a comment or question below and a KnovaSolutions nurse or pharmacist will reply.

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The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider.  If you have concerns about your health, please contact your healthcare provider.

 


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