Life

1 in 3: Could You Be Prediabetic?

The prevalence of prediabetes is well established.

At least one in three individuals could have blood glucose levels higher than normal and are at an increased risk for developing type 2 diabetes — and along with it,  a higher risk for heart disease and other complications.

Many people fall into this category and don’t even know it from lack of regular check-ups.

“There has been a growing recognition that prediabetes is a huge problem, but there hasn’t been a national movement or enough local initiatives to educate people about the need for dramatic lifestyle changes,” said Khurram Nasir, M.D., M.P.H. research director of Baptist Health’s wellness and prevention program, as well as director of the High Risk Cardiovascular Clinic and senior research scholar for Baptist Cardiac & Vascular Institute.

The U.S. Centers for Disease Control and Prevention says that 35 percent of U.S. adults aged 20 years or older have prediabetes, while 50 percent of those aged 65 years or older have it. These numbers are based on studies done from 2005 through 2008.

The figures are derived from fasting glucose readings, or A1c levels. The A1c is a common blood test to diagnose type 2 diabetes. The higher your A1c, the poorer your blood sugar control.

Most people are familiar with blood glucose levels, measured by your doctor in common blood tests after a fasting period.  Blood glucose levels of 100-125 mg/dl (under 100 is considered normal) after an overnight, or eight-hour fasting period, may signal prediabetes. People with these results have impaired fasting glucose (IFG).

The limit for diagnosing prediabetes was moved from 110 mg/dl to 100 mg/dl years ago, which contributed to the growing number of prediabetics.

However, the biggest factor for the explosive growth has been the obesity epidemic, largely a result of an increase in sedentary lifestyles combined with less engagement in regular exercise, Dr. Nasir said.

The problem starts with our kids, who are now less active because of the proliferation of  technology such as video gaming and other digital distractions. Meanwhile, there is less of a focus on physical education in schools.

“It’s with our children where we see the early signs of this epidemic,” Dr. Nasir said. “At a grass root level, to halt the emerging epidemics of prediabetics, there needs to be an early recognition of these issues, as well dedicated efforts and programs promoting healthy eating and encouragement to increase physical activity.”

For the adults, there also needs to be greater involvement by primary doctors in recognizing early warnings, including elevated blood pressure and cholesterol readings, and “initiating lifestyle intervention prior to developing full blown diseases,” he said.

Prediabetes is often accompanied by other problematic conditions, such as prehypertension (blood pressure readings higher than 130/85) and high cholesterol levels.

Despite the pervasiveness of prediabetes, it’s important for those who are prediabetic to understand that there is a silver lining.

Studies have shown that those people who lose weight, improve their diet and increase their physical activity can prevent or delay type 2 diabetes, and in some cases, return their blood glucose levels to normal.

Here are some of the primary risk factors for prediabetes:

Being overweight. This is a major risk factor for prediabetes. The more fat you carry — especially around your abdomen — the more resistant your cells are to insulin and the higher propensity for diabetes.

Inactivity. The less active, the greater your risk. Physical activity — aerobics and weight training — help control your weight and utilizes glucose as energy. This makes your cells more sensitive to insulin.

Advancing age. The risk of prediabetes increases as you get older. This could be because people tend to exercise less, lose muscle mass and gain weight as they get older. But it’s important to know that older adults are not the only group at risk for prediabetes and type 2 diabetes. The incidence of prediabetes is rising in younger age groups.

Family history. The risk of prediabetes increases if a parent or sibling has type 2 diabetes.

Race. It is unclear why, but people of certain races — including African-Americans, Hispanics, American Indians, Asian-Americans and Pacific Islanders — are more likely to develop prediabetes.

Here are key steps to take if you are prediabetic:

1.) Become more active
Physical activity is an essential part of combating prediabetes and helping prevent type 2 diabetes.

Regular exercise can lower blood glucose levels and decrease body fat. Studies have shown that people with prediabetes who lose 5 percent to 7 percent of their body fat are able to cut their probability of getting diabetes by greater than 50 percent.

The American Diabetes Association says that you can lower your risk for type 2 diabetes by 58 percent by losing 7 percent of your body weight (or 15 pounds if you weigh 200 pounds). Exercising moderately (such as brisk walking) 30 minutes a day, five days a week is highly recommended as a starting point.

2.) Eat Better
Certain fruits and vegetables should rule the day, especially spinach, broccoli, carrots, and green beans. High-fiber foods are recommended, as are whole-grain foods instead of processed grains.

Stay away from trans fat, which is not naturally found in foods — it is added to many processed foods, such as potato chips, crackers, croissants, pizza dough, muffins and many other baked goods because it is cheaper and has a longer shelf-life.

Avoid breads, breakfast cereals, cookies, cakes, muffins and all other grain-based foods made from refined flours. Choose non-fat dairy such as skim milk, non-fat yogurt and non-fat cheese. Eat lean meats and include fish in your meals 2-3 times a week.

3.) Monitor Your Blood Sugar More Often
This entails seeing your doctor more often once you are diagnosed as prediabetic. That helps you keep track of blood sugar levels every six months or so. If you are doing well, you can get positive reinforcement from doctor visits. More importantly, if you are not making progress, your doctor can help you get back on track.

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With internationally renowned centers of excellence, 13 hospitals, more than 23,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.