Are You at Risk For Prediabetes

 

Are you at risk for prediabetes?

It is estimated that more than 18 million people in the US have diabetes. There are serious lifestyle and health consequences for sufferers. The great news is that if the warning signs are caught early, the vast majority of the more than 1.3 million people who are at risk for diabetes each year can avoid developing this life-threatening disease.

The challenge, according to Claresa Levetan, MD, division chief of endocrinology at Drexel University College of Medicine, is that prediabetes, a condition that foreshadows diabetes, has no symptoms. You feel fine, with no warning signs of danger, until one day you go to the doctor for something unrelated and it's discovered. By then, however, prediabetes has already damaged your body.

What Exactly is Prediabetes?

Prediabetes has a simple definition and is easy to diagnose. It simply means that your blood sugar levels are too high but you don't have diabetes yet.

How do you know? If blood tests taken during your annual physical show that your sugar levels are too high, your doctor will recommend one of two follow-up blood tests: the Fasting Plasma Glucose test (FPG) or the Oral Glucose Tolerance Test (OGTT).

The FPG test is easier to administer, because it measures fasting blood sugar first thing in the morning, before you eat anything. Be sure to tell your doctor the time and composition of your evening meal. This will add precision to the results.

For the OGTT, you drink a high-glucose liquid, and then remain in the doctor's office for two or more hours while your blood is tested several times. This is a more detailed test, but a little unrealistic, since few of us would consider consuming the 100 grams of glucose used in the test in one sitting. Hence a possible condition may be identified that does not exist in everyday life.

Who Should be Screened for Prediabetes and When?

Type 2 diabetes, the kind that people develop as an adult or child, has both a genetic component as well as a lifestyle component that puts people at risk. Although experts don't yet know why, if diabetes runs in your family, you're at increased risk.

As for lifestyle indicators, believe it or not there is such a thing as pre-prediabetes and it's called metabolic syndrome. I talked about metabolic syndrome and its connection to heart disease and stroke in the June 7, 2004, issue of Daily Health News. Now, doctors have found that metabolic syndrome also is an indicator of prediabetes. Indicators of metabolic syndrome - and that you need to have your blood sugar checked - are...

Central obesity - excess fat around your middle. Waistline measurements shouldn't be more than 35" for women and 40" for men.

Low HDLs and high triglycerides. If your HDL is lower than 50 milligrams per deciliter (mg/dL) (women) or 40 mg/dL (men) and your triglycerides are 150 mg/dL or greater.

High blood pressure, defined as greater than 130/90.

Insulin resistance. This means that despite a high level of insulin in the blood, your blood sugar is still high. Dr. Drexler explains that with insulin resistance, the body requires more insulin than normal to achieve the same effect. You will not find this out from a fasting blood sugar or an oral glucose tolerance test. Your doctor will need to test your insulin level.

Body Mass Index, or BMI, above 25 for Americans. (In some other cultures, the BMI recommendation is much lower, because the population of these countries have smaller frames and the definition of overweight starts at a lower point on the BMI scale.) The National Institutes for Health has a BMI calculator you can use at www.nhlbisupport.com/bmi/

Cortisol - insulin syndrome. Daily Health News contributing editor Andrew Rubman, ND, adds that chronic stress (either psychological or physical) and its strain on your adrenal glands to produce cortisol also impact metabolic syndrome. The impact can be measured with a comprehensive hormonal panel that examines hormonal residue in the urine.

At what age do you need to worry? At this year's Diabetes Mellitus Consensus Conference held by the American Association of Clinical Endocrinologists, it was decided that the screening age for diabetes should be lowered to age 30 from age 45 for people at high risk in order to detect prediabetes early.

How Do You Prevent Metabolic Syndrome from Turning into Prediabetes?

The good news is that both metabolic syndrome and prediabetes improve markedly with a good diet, supplementation and exercise.

While that seems to be the answer to every health problem lately, it's a fact we all have to face. Too much fast food and too much television are the culprits, says Andrew Drexler, MD, director of the New York Diabetes Program and clinical associate professor at NYU School of Medicine. If you don't change the way you live your life, you raise your risk of developing diabetes dramatically.

Some doctors have begun prescribing metformin (Glucophage), a drug taken by diabetics, to reduce blood sugar levels in people with prediabetes, but Dr. Drexler doesn't believe this is the best treatment. He says that diet and exercise should be your first line of attack. Dr. Rubman's first line of defense? Nutritional supplementation along with dietary and exercise changes. He suggests taking chromium, a multiple B supplement, and lowering your intake of high-glycemic carbohydrates.

Making Change a Reality

Carolyn Robertson, who is board certified in advanced diabetes management and is a certified diabetes educator, offers some practical suggestions that make life changes easy...

Eliminate 500 calories a day from your diet and you'll lose a pound a week. While it sounds like a lot of calories per day to cut out, you may be surprised at how easily you can do it with simple changes, such as eating a turkey sandwich instead of a hamburger... skipping snacks... or using low-fat vinaigrette on your salad instead of creamy dressings.

Here are some easy ways to get in extra steps...

  • Walk, walk, walk.
  • Park your car at the far end of the lot.
  • Get off the bus or train one stop before your regular stop.
  • Walk the stairs instead of taking the elevator.
  • If you don't like walking up, take the elevator up and walk down. Down counts, too.
  • Take the long route to your office.
  • Instead of calling or instant messaging a co-worker, walk to his/her office.
  • Enlist the aid of friends and family. You don't have to join a weight loss group to lose weight. Friends and family will help support you in making more healthful dietary choices - and may even exercise with you. No doubt their lifestyles need some improving as well.

Consider the fact that, should your metabolic syndrome or prediabetes develop into diabetes, you run the risk of losing your vision, kidney function and even your legs. (The disruption of metabolic control causes damage to both the small and large vessels of multiple organs. The eyes, kidneys and lower extremities are especially vulnerable.) With awful consequences like these, those snacks hardly seem worth it.

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This article was provided by Bottom Line's Daily Health News. Bottom Line's vast network of leading mainstream, alternative, and complementary practitioners brings you the information you need to make informed decisions about your health. Sign up now for their FREE electronic newsletter.

Reprinted with permission of:

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