Features April 2016 Issue

Campaign Seeks to Educate Public about Prediabetes

An estimated 86 million Americans have elevated blood glucose levels, but lifestyle changes can often help prevent the progression to diabetes.

When your blood glucose (sugar) levels are higher than normal, but not yet at the point where you can be diagnosed with full-blown diabetes, you are said to have prediabetes. It’s the stage right before type 2 diabetes, which raises the risk of numerous cardiovascular and other health concerns.

You may be hearing a lot more about prediabetes these days, as the Centers for Disease Control and Prevention (CDC), the American Diabetes Association and other health organizations work together on a public awareness campaign focused on this serious condition.

The campaign is especially important these days, given the recent report in the Journal of the American Medical Association that the number of people estimated to have diabetes or prediabetes in the U.S. is approaching 50 percent of the population, says Betul Hatipoglu, MD, with Cleveland Clinic’s Endocrinology & Metabolism Institute. The campaign message is: No one is excused from prediabetes.

“Even though the numbers of diagnosed type 2 diabetes cases have slowed down lately, prediabetes remains an alarming health issue,” she says. “As prevention is, of course, the most important way of fighting any disease, for diabetes, awareness and screening of the public are the keys to control this disease. You can almost look at it like a vaccination for infectious diseases. Awareness and early diagnosis are like a vaccination for diabetes.”

Defining Prediabetes

Perhaps the most common way prediabetes is diagnosed is through a fasting plasma glucose (FPG) test, which is part of a standard blood test. You don’t eat for at least eight hours before you give blood. An FPG score of 100 mg/dl to 125 mg/dl indicates prediabetes. Diabetes is defined as an FPG test of 126 mg/dl or higher. A normal or healthy FPG is anything less than 100 mg/dl.

There are two other main tests that measure blood glucose levels in the body. The oral glucose tolerance test checks your levels before and after you drink a special, sweetened drink. The A1C test measures the average of your blood glucose levels during the precededing two to three months.

To confirm a diagnosis of prediabetes or diabetes, a test is usually given twice. If both measurements are elevated, your doctor can make a diagnosis with some confidence.

Blood Glucose tests for prediabetes

When Prediabetes is Diagnosed

One of the reasons the CDC and other organizations are spreading the word about prediabetes is because diabetes can damage your blood vessels, nerves, and kidneys, and it can raise your risk of high blood pressure and other health problems.

“While it may sound like bad news, in reality, I tell my patients that this is a second chance,” Dr. Hatipoglu says of a prediabetes diagnosis. “They have been granted a chance to reverse this disease. They can either continue the way they have been until that moment and they will be diabetic with time. Or they can make changes and reverse back to normal. This is a choice they have to make.”

The biggest choice, however, is to change your lifestyle, Dr. Hatipoglu says. She recommends the Mediterranean diet, with its focus on fruits, vegetables, whole grains, nuts, lean proteins, fish and healthy oils, and its recommendation to skip processed foods, sweets and other low-nutrient foods.

More exercise is also vital to bringing down your blood glucose levels.

“The most important intervention is exercise,” Dr. Hatipoglu says. “Anything and everything will count. Accumulate 10,000 steps a day, walking while talking on the phone, parking far from your destination, using stairs, taking nature walks, dancing—anything that is fun or increases daily movement counts. We usually recommend 150 minutes of walking a week, and twice-a-week strength training if possible.”

She adds that most people who stick to a diet and exercise routine reverse the course of prediabetes.

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