Prediabetes

What is Pre-diabetes?

Pre-diabetes is a condition that is a pre-cursor state to Type 2 Diabetes. If you have pre-diabetes, you will have higher than normal blood sugars. Pre-diabetes causes what is called insulin resistance, which means that your cells in your body are unable to process sugar effectively and are more resistant to the hormone insulin. Because pre-diabetes commonly affects those who are overweight or obese, the rate in the U.S. has increased dramatically in the past decade. Those who have pre-diabetes are at high risk of developing full-blown diabetes in the future, especially if they do not make healthy changes in their lifestyle. Many are unaware of their condition.

How someone develops pre-diabetes?

Due to genetics, low activity, excess body weight, and a poor diet, the muscle, liver and fat cells in your body can gradually become resistant to insulin, a hormone made by the pancreas, which is an organ in your body. Insulin is responsible for sugar control. Without insulin, cells cannot process the sugar in your body very well, resulting in “cell starvation” and higher blood sugars. The pancreas may respond to this “cell starvation” by secreting more and more insulin as the disease progresses from pre-diabetes to full-blown diabetes. In those who have type 2 diabetes, which can more likely occur in pre-diabetics who do not make changes in their lifestyle, the pancreas eventually slows or stops secreting insulin altogether. (animation with voiceover for this section)

What are the risk factors for Pre-diabetes?

Risk factors include:
1) Overweight or obesity (defined by a Body Mass Index or BMI >25)
2) Asian, Latino, African or American Indian descent
3) Family history of diabetes
4) Low activity levels/lack of exercise.
5) Overeating and eating foods high in fat, cholesterol, and sugars.
6) Older age ( >45yrs).
7) History of diabetes in pregnancy.
8) Polycystic ovary disease

How do I know if I am pre-diabetic?

You should be screened for diabetes or pre-diabetes if you have any of the risk factors above. Screening for pre-diabetes is done by checking a fasting blood sugar test after a 12-14 hr fast, or by having a glucose tolerance test, which requires you to ingest a sugar drink and then have your blood sugar checked 2 hrs afterwards. (show pt drinking orange drink, sitting in chair waiting)

You will be diagnosed with pre-diabetes if:

1) Your fasting sugar is between 100-125 mg/dl; or
2) Your blood sugar level two hours after a sugar drink is between 140-199 mg/dl.

How do I prevent getting diabetes if I am pre-diabetic?

If you have been diagnosed with pre-diabetes, the best thing you can do to prevent full-blown diabetes is to live a healthy lifestyle. Studies show that even modest weight loss and lifestyle changes can significantly decrease the chance of diabetes.


It is recommended that you:

1. Try to lose weight and get regular exercise.
You should exercise for at least 30 minutes most days of the week, after getting a medical clearance from your doctor. However, even smaller amounts of moderate exercise such as walking and simply increasing activity levels (for instance, taking the stairs rather than the elevator, or gardening) can help to prevent diabetes.

2. Modify your diet
Eat a healthy diet, avoiding excess sugars and desserts, high carbohydrate or starchy foods (such as potatoes, or white rice), and sugary drinks such as soda-pop. Better sources of carbohydrates include whole grain breads or cereals, pasta, brown rice, beans, fruits and vegetables.

Also try to avoid foods high in fat, such as red meat, fried foods or junk food. Consider eating skinless chicken or poultry, fish, tofu, egg whites, and beans/legumes as a source of protein in your diet.

It is also important to cut down on serving sizes in general. If you are at a restaurant, don’t feel pressured to eat everything on your plate if you are given a large portion of food. You can always bring food home with you!

Dieting doesn’t mean that you can never eat foods that you like. Rather, try to limit the quantities of less healthy foods by replacing them with food that are more healthy. Talk to a dietition for more information on how to maintain a healthy diet.

Are there other ways to treat pre-diabetes?

You can also treat pre-diabetes with a medication called metformin, but it is up to your doctor to determine whether this is the right therapy for you. The most important thing is to stay active and eat a healthy diet.

http://ndep.nih.gov/diabetes/pubs/2005_National_Diabetes_Fact_Sheet.pdf
http://diabetes.niddk.nih.gov/dm/pubs/type1and2/what.htm#2

Copyright 2007, MD Kiosk