Fighting the prediabetes epidemic

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Prediabetes means blood sugar is above normal. Here’s what to know to prevent this from becoming full-blown diabetes.

Prediabetes affects about 88 million American adults. That’s more than one out of three people. Of the people who have prediabetes, more than 84 percent don’t know they have it.

Prediabetes means that someone’s blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. Although usually a fasting blood glucose or A1C test (a blood test that measures average blood sugar level for several months) is used for diagnosis, a prediabetes diagnosis can come from bloodwork typically done during a physical. Often, there are no symptoms at this stage.

We can fairly call prediabetes an epidemic, meaning it is widespread. There are more undiagnosed cases than diagnosed cases, and numbers continue to rise. In Tennessee, part of the “diabetes belt” that runs through much of the South, 13.1 percent, or more than 650,000 adults, have been diagnosed with diabetes as of 2017. Nationally, about 9.4 percent of the U.S. population has diabetes.

While weight is not the only risk factor, it is an important one. Physical inactivity is common and a culprit in this condition, as is our Southern-fried diet.

Dreary news? Hang on. There’s hope.

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Vanderbilt Diabetes and Endocrinology can help you reach your best health through a comprehensive approach to your care.

How to prevent or delay type 2 diabetes

The National Institutes of Health led a nationwide randomized study of 3,234 people who were overweight and diagnosed with prediabetes. Published in 2002, the study showed that even modest weight loss and exercise dramatically reduced their chances of developing diabetes.

Now we know that a 7 percent loss of body weight and changes in physical activity can lower a person’s risk of developing type 2 diabetes by 58 percent. Lifestyle changes for participants in Diabetes Prevention Programs recognized by the CDC, reduces risk by 71 percent. For example, if a person who weighs 200 pounds loses just 10 to 14 pounds, that’s a game changer in terms of lowering the chance of developing diabetes, which is irreversible.

We can now prevent or delay the onset of type 2 diabetes, which helps to lower occurrence of the disease. That’s why it is such a big deal to take action when you learn you have prediabetes.

Manageable ways to add activity

The research shows that changing habits makes a big difference. CDC-recognized lifestyle-change programs provide trained coaches and use a CDC-approved curriculum to help people with a prediabetes diagnosis. Some of these effective programs are covered by employer-sponsored health plans and by some Medicare and Medicaid plans.

Whether you enroll in an actual program or not, you can still find  manageable ways to incorporate more activity. If you sit for long periods, get up every 30 minutes for a stretch, do shoulder rolls or walk in place. Work regular walking into your day. You don’t even need a long walk, though those are a good thing. There are many ways to sneak short walks into your day.

Take the stairs, walk in from the parking garage or take 10 minutes of your lunch break to walk around the building. The important thing is to keep moving.

Are you at risk for diabetes?

Besides being overweight, another risk factor is age — we are more likely to have diabetes the older we get. If you are older than 45, ask your primary care provider for a blood glucose test.

Some other risk factors:

A family history of the disease.
Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian or Pacific Islander.
Having a baby weighing more than 9 pounds.
Having high blood pressure.
Being physically inactive.