Prediabetes, A Scary Diagnosis

Article by: Clark Stream, PA-C

Prediabetes, formerly known as boarder line diabetes, is a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. There are almost 80 million people in the United States who have prediabetes. Research has shown that long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes.

How to Tell if You Have Prediabetes.

There are three tests your doctor can use to determine whether you have prediabetes:

• The A1C test
• The fasting plasma glucose test (FPG)
• or the oral glucose tolerance test (OGTT).

The blood glucose levels measured after these tests determine whether you have a normal metabolism, prediabetes or diabetes.

If your blood glucose level is abnormal following the FPG, you have impaired fasting glucose (IFG); if your blood glucose level is abnormal following the OGTT, you have impaired glucose tolerance (IGT). Both are also known as prediabetes

Prediabetes is a serious medical condition that can be treated. The good news is that the recently completed Diabetes Prevention Program (DPP) study conclusively showed that people with prediabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity.  
Who should get tested for prediabetes?
If you are overweight and over age 45, you should be checked for prediabetes during your next routine medical office visit.  For adults younger than 45 and overweight, your doctor may recommend testing if you have any other risk factors for diabetes or prediabetes. These include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 9 pounds, or belonging to an ethnic or minority group at high risk for diabetes.

What is the treatment for prediabetes?
 Treatment consists of losing weight (5-10 percent of total body weight) through diet and moderate exercise, such as walking, 30 minutes a day, 5 days a week. Don't worry if you can't get to your ideal body weight.  A loss of just 10 to 15 pounds can make a huge difference.  If you have prediabetes, you are at a 50% increased risk for heart disease or stroke.  Your doctor may wish to treat or counsel you about cardiovascular risk factors, such as tobacco use, high blood pressure, and high cholesterol.


What is the diet for prediabetes?

The American Diabetes Association recommends plenty of fruits and vegetables, nuts, and eat more fish.  Avoiding both saturated and trans fats are a heart healthy choice.  Together, these fats can increase your total and bad (LDL) cholesterol levels while the trans fats can lower your good, (HDL) cholesterol. 

With Halloween just around the corner, can your eat candy?

Yes, if you follow some simple rules.  Beware of chocolate with trans-fat from partially hydrogenated oil.  Be warned!!  Sugar free candy is not always the best choice.  Look for artificial sweeteners and read the nutrition labels.  Candy with low fat and carbs, enjoyed in reasonable portions are your best choice.  For the prediabetic, candy does not have to be scary.