November is Diabetes Month, and There’s a Good News Story to Tell About Prediabetes

Linda Gaudiani, MDAlthough most of us welcome the holiday season, the month of November, with the end of daylight savings time, means we are entering the dark time of the year. November is also National Diabetes Month, and it’s a perfect opportunity to shine some light in these darker days with some good news about prediabetes. Affecting 86 million US adults, prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be called type 2 diabetes.

Here’s the good news. Research shows that prediabetes is largely preventable and reversible, without medications or other high-risk interventions. Plus, some low-risk medications, when added to lifestyle changes, can further reduce A1c for pre-diabetics who have not quite reached goal. More than 50% of patients who have prediabetes can significantly decrease their progress toward type 2 diabetes with two important and achievable changes in lifestyle.

  • Lose just 7% of your body weight (for example, 15 pounds if you weigh 200 pounds)
  • Engage in moderate exercise (such as brisk walking) 30 minutes a day, five days a week.

Prediabetes is typically a silent disease, with no distinct outward symptoms. Your body’s cells, meanwhile, are not responding as well to the amount of insulin your pancreas is producing; your pancreas then has to produce more insulin to keep blood glucose levels normal but is having a hard time keeping up. Blood sugar levels rise, eventually leading to a diagnosis of type 2 diabetes.

We know the risk factors for developing prediabetes, and although not everyone who fits into these categories will develop the disease, they have been shown to be strong indicators:

  • Being overweight
  • Being over age 45
  • Your parent, brother or sister has type 2 diabetes
  • You are physically inactive
  • You are African American, Hispanic/Latino, American Indian, Pacific Islander, a Southeast Asian American);
  • You had gestational diabetes (diabetes during pregnancy) or had a baby weighing more than nine pounds at birth.

More good news. If you think you may have or be at risk for prediabetes, there are many resources to help. The best place to start is with your physician. One of the first things he or she will do is to order some form of blood glucose testing. Blood glucose tests are either random or fasting tests in which you can’t eat or drink anything but water for eight hours before your test. An A1C test, which tests your blood sugar average over a three to four month period, does not require you to fast before the test.

If your doctor has ordered an A1C test, here’s how he or she will interpret the results.

  • Below 5.7 percent, normal
  • 5.7 to 6.4 percent, prediabetes
  • 6.5 percent or higher, diabetes

The results will help your doctor to make recommendations for diabetes self-management and make a plan to continue monitoring your blood glucose levels and track your progress.

A diagnosis of prediabetes or type 2 diabetes may come as a surprise or even a shock to some individuals. Because of our western culture, however, especially with our high levels of inactivity and our tendency to overeat and choose not-so-healthy foods, people who have developed prediabetes are not in the minority. In 2015, 30.3 million Americans, or 9.4% of the population, had diabetes. More recent data shows the percentage at 12.4%. In 2015, 84.1 million Americans age 18 and older had prediabetes with recent data showing 35-40% with the condition. This raises the incidence of diabetes or prediabetes in the population to almost 50%!

We must, therefore, and we can, take steps to stop diabetes from making any more inroads into our lives. As a good first step, starting with the Center for Medicare Services (CMS) coverage for pre-diabetes education is now available for the Center for Disease Control (CDC) recognized programs. With the high prevalence of diabetes and prediabetes in our population, payers are beginning to realize that education and prevention can help decrease the huge financial costs of diabetes.

Check out your local diabetes education center (in Marin County, the Braden Diabetes Center at Marin General Hospital) for help in diabetes self-management. A variety of online resources, including websites for the Center for Disease Control (CDC) and the American Diabetes Association, can also be of great help.

Information is power. Use it wisely to stay healthy and live the quality of life you deserve.