What is Pre-Diabetes?

Most of us have heard plenty about Type 2 Diabetes. It is a serious condition causing abnormal elevations in blood glucose levels. Type 2 Diabetes now affects over 29 million Americans and is costing the healthcare system over $300 billion annually.

The cause of Type 2 Diabetes is multifactorial. A high BMI with an unhealthy diet is often the main culprit, but genetics may play a role as well.  Over time, diabetes leads to a host of other diseases, which is where the most considerable health damage is done. These include conditions such as neuropathies, heart disease, stroke, infections, and poor wound healing.

In terms of diagnosis, your doctor will sound the diabetes warning bell if you have an HbA1c above 6.5 and a fasting blood sugar over 125. Treatment often begins with drugs (Metformin is usually the first option) and diet and lifestyle recommendations.

But…..now more frequently we are hearing about what is termed Pre-Diabetes. Yikes, another type of diabetes? Well, sort of, but not exactly. Pre-diabetes is basically the beginning stages of blood sugar irregularities.  It is a critical point where we can catch people before they become full diabetic and in many cases even reverse the progression.  It is important that we all get a better understanding of this condition so we can combat the rising rates and healthcare costs of diabetes. To that end  let’s review the definition of pre-diabetes, the associated health risks, and effective preventative measures.

We already reviewed the diagnostic criteria for diabetes. For pre-diabetes, the ranges are just slightly lower. If your fasting blood sugar is running anywhere from 100-125 and your A1c comes back anywhere from 5.7 to 6.4, you will likely be labeled as pre-diabetic. This puts you at significant risk for diabetes within the next 4-10 years unless steps are taken to return your blood sugar to an ideal range.

This is where I would ask, if you happen to have them on hand or online, to go check your labs. Seriously, go check them! See where your fasting blood glucose is at and determine if you’ve had a recent A1c. The reason being? Many doctors are not diagnosing pre-diabetes. Studies have shown we have an under-diagnosis problem in this country when it comes to pre-diabetes. I’ve seen many clients in my office with pre-diabetic numbers and yet no one told them they were pre-diabetic. So yes, go check.

It is so valuable to know this information because pre-diabetes is EASY to treat with diet and lifestyle change. The studies show that diet and lifestyle are the number one way to reduce blood sugar numbers in pre-diabetic patients. Once you progress to full diabetes the chance of returning to normal blood glucose is much, much harder. NOW is the time to take action and correct.

If you are pre-diabetic and want to take steps now to avoid becoming diabietc, here are a few of the researched ways to get those numbers back under control.

DIET
Not surprisingly, diet of course is the primary area to address. From the research we see that that reducing carbohydrates helps immensely, as does decreasing overall calorie intake such that weight loss occurs. When diet and weight loss are tackled together, blood sugar begins going in the right direction as well. What kind of diet you ask? Multiple studies show the Mediterranean diet is a very helpful roadmap for an overall healthy diet. Thankfully multiple books, cookbooks, websites, and blogs have been devoted to this way of eating. Another similar approach is the anti-inflammatory diet. In both cases, think fruits, veggies, lean protein (especially fish), nuts, seeds and legumes…..you get the idea.

WEIGHT LOSS
As alluded to, weight loss is extremely important in normalizing blood glucose levels. In many studies they have found weight loss to be the most important factor in reducing diabetes risk. The theory is that being overweight increases inflammation in the body. Once the weight comes off and the inflammation subsides, blood glucose begins to return to normal. Of course diet is always interwoven with weight loss, so likely the diet plus the decrease in weight is working together. Whatever the cause, include modest weight loss in your plan and you should see results.

EXERCISE
Naturally we cannot talk about diet and weight loss without including exercise. Exercise helps support weight loss which we know improves blood glucose. Apart from helping with the weight, exercise also helps improve insulin sensitivity and increase metabolism, all of which help us clear sugar from the bloodstream more efficiently. It also supports a healthy heart and improves circulation, both of which are negatively impacted by high blood sugar.

DRUGS
In some cases, drugs are employed to help in the pre-diabetic state. If diet and lifestyle changes just aren’t working, or maybe you are at a place where you cannot implement these changes, doctors may prescribe drugs such as Metformin to support healthy blood glucose levels and slow the progression towards diabetes. Of course diet and lifestyle change remains paramount components, but drugs can often work in conjunction with other treatments when necessary.

SUPPLEMENTS
As you are likely well aware, there are many supplements on the market for diabetes. They are often marketed for pre-diabetes as well. Some of the ones you may have heard of include cinnamon, alpha lipoic acid, chromium and Omega 3’s. All of these have shown some promise in various studies conducted. While they can help support improved glycemic control, remember that diet and lifestyle changes are always the most important. Never rely on supplements as your primary means of blood glucose control.  They show modest results at best. Like medications, they can be helpful in conjunction with changes in diet, exercise and weight control.

Hopefully this review gave you a quick glimpse into pre-diabetes and a better understanding of where you stand in terms of blood sugar health. Like I mentioned, always review your labs and be keep tabs of where you are at. While doctors are very knowledgeable, sometimes they miss these early stages of disease where small changes now can lead to big decreases in risk later. Take control of your health and be on top of your numbers.

If you do find that you are pre-diabeteic, one of the best things you can do is talk to a Registered Dietitian! In fact, a recent study conducted found that RD’s were more effective in delivering health information to diabetics than other types of practitioners, resulting in greater improvement in diabetic markers over a 12-month period. What makes our job so great is that we get to sit down with clients one-on-one for up to an hour, really drilling down on each person’s unique diet and situation. We customize the plan to fit the client instead of forcing people to adhere to some standard regimen on a piece of paper. As the research shows, this results in better compliance and bigger changes in blood glucose.

So….along with knowing your numbers, know a dietitian! Get some support if you are looking to navigate new changes in your diet and overall health! That’s what I’m here for.