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Prediabetes Q&A

Throughout the month of November in celebration of American Diabetes Month, we will bring you facts about the prevention and the management of prediabetes and diabetes – starting with prediabetes.

According to the American Diabetes Association more than 79 million Americans have prediabetes.  In other words, their blood sugar levels are elevated, but not high enough to be considered diabetes.

How do you get prediabetes? 
The body’s primary source of energy is sugar (glucose). Sugar comes from breaking down carbohydrate foods such as fruit, milk and yogurt, sweets, and starches. Once the carbohydrates are broken down into sugar (glucose), the body produces insulin which acts as a key to allow the sugar to enter the cells and produce energy. 

Before people develop Type 2 diabetes, they almost always have prediabetes. Prediabetes is the inability of the body to use all the insulin it produces (insulin resistance). With insulin resistance all the cells do not easily recognize the insulin as insulin and will not allow the sugar to move from the blood to the cell. As a result, sugar remains in the blood leading to higher than normal blood sugars.

What can contribute to prediabetes?
Family history of type 2 diabetes, weight gain, being over 45 years old, a history of gestational diabetes or of delivering a baby weighing more than 9 lbs, elevated blood pressure and an inactive lifestyle can increase your insulin resistance.

Is there a test for prediabetes?
Yes, there are three different tests for prediabetes. (All results within these ranges are considered prediabetes.)

  • A1C test does not require fasting. It gives us an average of blood sugars over a three month period and is measured in percent. An A1C result is between 5.7%-6.4%
  • Fasting blood sugar between 100-125 mg/dl
  • Blood sugar after a 2 hour oral glucose tolerance test between 140-199 mg/dl or

Why is having prediabetes a concern?
People with prediabetes almost always develop Type 2 diabetes, and already have higher than normal blood sugar levels. People with prediabetes have a 1.5-fold higher risk of developing cardiovascular disease compared to those with a normal blood sugar.

High blood sugar damages artery walls and over time allows the buildup of fatty materials such as cholesterol (plaque) in the arteries. This damage can lead to stroke, heart attack, kidney damage, blindness, nerve damage and amputation of limbs.

Does prediabetes always develop into Type 2 diabetes?  
NO! Studies have shown that people with prediabetes can delay or prevent the development of Type 2 diabetes by up to 58% through changes to their lifestyle. Under a doctor’s care, overweight patients who have a modest weight loss (5% to 7% of body weight) and participate in a regular exercise like brisk  walking, cut their risk of Type 2 diabetes by 58%.

For those over individuals over 60, their risk is cut by 71%. For some people with prediabetes , being diagnosed early and taking preventative measures can actually return elevated blood sugar levels to normal.

In the next few weeks, watch for our blogs on Type 1 and Type 2 diabetes and the skills to manage diabetes.

Carol V. White, BSN, RN-BC is a Patient Educator in the Adult Diabetes Management Program with WakeMed Health & Hospitals