Pre-diabetes: Are you at risk?

Pre-diabetes means your blood glucose levels are higher than normal, but not high enough for you to be classified as diabetic. A diagnosis of pre-diabetes is a warning sign that should be heeded, as it means you are likely to develop Type 2 diabetes in the future, unless you take preventative action now.

The condition occurs when your insulin (the hormone that helps convert sugars from food into energy) is not working properly and can't move the glucose from the blood into the cells where it needs to be. This is known as insulin resistance.

How do you know if you have pre-diabetes? You can take a blood test, but the first thing to do is to check for risk factors. Take a look at the list below and see how many risk factors are true for you:

• Do you have a family history of diabetes?
• Are you overweight? 
• Is your waist larger than 35 inches (for a woman) or 40 inches (for a man)?
  
• Do you have a low level of physical activity?
• Are you over 65 years old? 
• Do you have a high triglyceride level? 
• Do you have a low HDL cholesterol level and/or a high total cholesterol level?
• Do you have high blood pressure (greater than 130 over 85)?
• Do you have a history of vascular disease? 
• Do you have Polycystic Ovary Syndrome? 
• Have you had gestational diabetes (diabetes in pregnancy) or given birth to a baby weighing more than 9lbs?
• What is your ethnic background? Native Americans, Africans, Latinos, Pacific Islanders, Asians and Indians are at higher risk of developing diabetes.
  

If you answered "yes" to two or more of these questions, you are at risk for pre-diabetes.

Left unmanaged, pre-diabetes can develop into Type 2 diabetes within five to ten years, and this is the biggest risk. The American Diabetes Association says that over 1.5 million people were diagnosed with diabetes in 2005.  The bad news is the trend is an upwards one, with diabetes  having an increasingly detrimental impact upon the length and quality of life of Americans.

The best way to put the brakes on these dramatic figures is through the early diagnosis and treatment of those at risk for pre-diabetes. “Making the diagnosis of prediabetes is extremely important,” notes Joslin Diabetes Center’s Dr. Richard Jackson, "since clinical studies have shown that the progression from prediabetes to diabetes can be prevented.”

Studies in diabetes prevention have shown that if people are diagnosed and treated for pre-diabetes, their chances of developing Type 2 diabetes decrease dramatically. For some people with pre-diabetes, intervention can actually turn back the clock and return elevated blood glucose levels to the normal range. That's why it's so important to get checked out if you think you are at risk.

The only way to diagnose pre-diabetes is through a blood glucose test.

Two different blood-glucose tests can be used: The fasting plasma glucose test (FPG), in which blood glucose is measured after fasting overnight, or the oral glucose tolerance test (OGTT), in which blood glucose is measured after fasting overnight, and again after drinking a glucose-rich drink.

The FGP will show three possible diagnoses:
Normal. A fasting glucose between 70 and 100 milligrams of glucose per deciliter of blood (mg/dl);
Pre-diabetes. A fasting blood glucose level between 100 and 125 mg/dl;
Diabetes. Fasting glucose above 126 mg/dl.

The OGTT test will show three possible diagnoses:
Normal. Glucose is at 140 mg/dl;
Pre-diabetes. Glucose is at 140-199 mg/dl;
Diabetes. Glucose levels above 200 mg/dl.

Surveys show that while many people are aware of their cholesterol and blood pressure, few know their blood glucose level. If you are older than 45 and overweight, you should have regular blood glucose checks. If you are younger than 45, but have one or more risk factors for pre-diabetes, you should also have regular testing. The American Diabetes Association recommends that those with normal blood glucose should retest blood glucose levels every three years, while those with pre-diabetes should be retested for Type 2 diabetes every one to two years after diagnosis of pre-diabetes.

The good news about pre-diabetes is that it can be treated, and through treatment, the onset of Type 2 diabetes can be delayed or even prevented.

Whether you want to prevent getting pre-diabetes or reduce your chances of it progressing to Type 2 diabetes, the advice is the same. You need to make changes to your lifestyle by doing regular physical activity and eating healthily.

Here are some tips for making these lifestyle changes:

• Eat foods that are low in fat and high in fiber, such as fruits and vegetables, beans, whole-grain breads and cereals
• Space your meals evenly throughout the day
  
• Aim for at least 30 minutes of physical activity most days of the week 
• Remember to talk to your doctor before starting a new type of exercise to make sure it's safe 
• Reduce your weight by 5-10 percent, as even a small weight loss has been found to make a big difference in the impact of pre-diabetes 
• Maintain your weight loss 
• Include the whole family in lifestyle changes - look after the future health of your children by teaching them healthy behaviors
  

By taking action to manage your blood glucose when you have pre-diabetes, you can prevent Type 2 diabetes from ever developing – and that’s good news!