Diet and lifestyle changes work to effectively treat pre-diabetes
James Rogers, M.D.
Diabetes is a life-long disease that affects about 18 million Americans. According to the Center for Disease Control, over twice that number, about 40 million, have the condition known as pre-diabetes, and two million of these are youth under the age of 18. Most people with pre-diabetes are unaware that they have the condition.
Pre-diabetes is often the precursor to diabetes. Although people with the condition usually show no symptoms, their bodies have an impaired ability to handle blood sugar, which is similar to those with diabetes, but not as severe. According to the American Diabetes Association, if left unchecked, many people with pre-diabetes will develop full-blown type 2 diabetes within 10 years. The condition is also associated with an increased risk for heart attack and stroke.
Often, pre-diabetes shows no symptoms. However, sometimes symptoms similar to those of diabetes – unusual thirst, frequent urination, blurred vision, and extreme fatigue – occur with pre-diabetes.
To test for pre-diabetes, doctors check the level of glucose in the blood in one of two ways. The first is called a fasting plasma glucose test (FPG). With this test, a person doesn't eat or drink anything within a certain time frame before the test. A second test is the oral glucose tolerance test (OGTT), where a patient consumes a glucose-rich drink before the test. With both the FPG and OGTT, significantly elevated glucose levels in the blood indicate diabetes. Slightly elevated levels indicate pre-diabetes.
Diabetes and pre-diabetes are related in numerous ways, but there is one major difference between the two. People with diabetes will have the disease for their entire life. People with pre-diabetes have the opportunity to reverse the condition and delay or even stop the onset of diabetes before it occurs.
This reversal can be accomplished with diet and lifestyle changes. Treatment includes eating healthy to lose weight. It's been shown that a five to 10 percent decrease in weight can make a big difference in treating pre-diabetes. For a 200-pound person, this would mean a modest 10 to 20 pound weight loss.
Exercise goals include engaging in physical activity for 30 minutes a day five days a week. Activity can be split into three 10-minute increments each day. The overall goal is to get 150 minutes of exercise a week.
Other lifestyle changes include quitting smoking. People with high blood pressure and high cholesterol are encouraged to follow treatment plans outlined by a doctor. Medications that work to sensitize the body to the actions of insulin may also be prescribed to further augment diet and lifestyle changes.
In addition to diet and lifestyle, there are certain factors that put people at greater risk for developing pre-diabetes. These include: a family history of type 2 diabetes, a history of gestational diabetes, polycystic ovary syndrome, being overweight or obese – especially around the waist, inactivity, and age – older people tend to have a decreased ability to process glucose. Certain minority groups such as African Americans, Native Americans, Latinos, and Pacific Islanders have an increased risk, as do people with a condition known as metabolic syndrome, which is characterized by a cluster of symptoms including high LDL cholesterol, low HDL cholesterol, high triglycerides, abdominal obesity, hypertension, elevated blood pressure, and insulin resistance.
It is recommended that everyone over the age of 45 be tested for diabetes and pre-diabetes every three years. In addition you should be tested if you have any risk factors for diabetes listed above, are overweight with a body mass index over 25, or have had an abnormal glucose tolerance or fasting test in the past.
Identifying pre-diabetes is important because it can prevent or delay the development of diabetes. This lowers your risks of complications associated with diabetes such as heart and blood vessel disease, stroke, eye disease, kidney disease, poor circulation, digestive problems, nerve damage, gum disease, mouth problems, and increased infections, ulcers, and risk of amputations.
Pre-diabetes is not a life sentence. It does not have to be the beginning of a long list of physical complications. Instead, it can be the beginning of a new, healthier way of life. With the right changes to diet and lifestyle, pre-diabetes can be reversed, putting you back in charge – of your own bright future.
Dr. Rogers is a board certified family practice physician at Raiter Clinic.